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ELECTRICAL PERMIT APPLICAT'ION <br />CITY O� EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />9l� s� �v�. ��-c� w�y S�c�;� �ar <br />FROJECT ADDRESS <br />� <br />Ownef MailAddress City Staie/Zip ��/ Phone <br />��' \ <br />Tenant <br />,(� _ R � o��, <br />Electrical Contraclor <br />[,aC%L <br />A1ail Address <br />ti� ���c lo� � <br />Mail Add�ess <br />D2tUDE��61i37 <br />State License Number <br />��������� <br />Proposed Use of Building <br />City <br />f�, �L S�vJ f—"INNWU( <br />Square Foolage (If residenlial new conslruction, remodel or addition) <br />Number of devices (If low vollage) <br />City <br />StalelZip <br />G.i�- j��S <br />Sta�e/Zip <br />Phone <br />Phone <br />`o� S p U. C� v <br />Contract Price of Work ; <br />Jv��✓� �2 opi�G <br />Contacl Person (Plan Review) <br />Description o( Work to Be Done: .�� �U KES ��%1Z /J L lJ �"'� ��� � 5 � 'r� � ��� S �S � — <br />RrcCC-�iRCG�F.s �5 � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 he�eby certily that I have read and examined this application and kno�•✓ the same to be true and <br />conect. All provisions o(laws and ordinances c�ovemino this type of work ivill Ge completed <br />�vhefherspeci(ed herein ornot. The granling o(a pemiif does nol presume fo gi✓e aufhority to <br />violate or cancel the provisions ol any olher slate orlocallaw r�egulating consbuction or the <br />peAomiance af const�uction. THat 1 am au(horized by lhe o�vner of Ihis property to peifonn the <br />�vork (or which application is made and 1 comply e�ifh the State Conliactors Law 'I8.27 RCW and <br />296.2001�� ^ <br />� <br />� ,:,_�.;���� ..; ,, <br />c>�.�(-'1a�3 <br />FEE <br />j ( � � �� <br />PERMIT# <br />Ef30�-)3a <br />