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� <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EV�ERF:TT PERI�IlT SERVICES <br />3200 CED�aF� uTREET, EVERETT, WA 98201 <br />425-257-8tf10 - FAX 425-257-8857 — www.everettwa.org <br />Gi 2,� �z ZVeI'� l�'ir�t/1�ti� <br />PROJECT ADDRESS <br />�-a�-i�t <br />� � y�a- �30 <br />Owner Mail Addre,s C�ly StatelZip Phone <br />6� S� �✓Gr�� �uu�.e��� <br />���f � ��.��.� ��k-�-� w �- 9��� <br />Tenant Mail Address � q Ciry State/Zip Phone <br />� N r,J & I,L-��21c � R v� �� s 3� �� l �Pe `� I�U-� (,� Id ��Z3 ��6�6/ <br />" z rd rz�� S�-- _ cQ�� <br />Electrical CoNraclor Mail Address <br />���v � ���s q�S bL <br />License Number <br />Proposed Use o( Building <br />Square Foolage (If residential new construction, remodel or addilion) <br />Number of devices (If low voliage) <br />Descriplion of Work to Be Done ��� '�'� <br />u�ed' 3 � �r ���2 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />�r <br />SlalelZip <br />Contract Price of Work <br />Contacl Person (Plan Review) <br />a�tiGl� ,. <br />I hereby certify that I have read and examined this applicafion and know fhe same fo be (rue and <br />correcL All provisions of laws and o�dinances goveming this type o(work will be comple(ed <br />whe(herspecified hemin ornot The granling ol a permit does nof presume to give aulhority fo <br />violafe or cancel the provisions o(any other stafe orlocallaw regulafing consfrucfion orthe <br />pedonnance o/consWc(ion. That I am authonzed 6y the owner o/this properfy lo peAorm !he <br />work /onvhic �cation is ma nd I compiy with (he Stafe Conlractors Law i8.27 RCW and <br />296.200 W C. /% <br />82— 2 � — � <br />FEVISEO ]/iNi) <br />Phone <br />FEE <br />��'�0 <br />PERMIT# <br />E i �02� I 3v <br />