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ELEGT41C:aL PlERMIT APPLICATIUN <br />CITY OF EVERETT PERMlT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - �vww.everettwa.org <br />- � `I /h%<- �✓�� ._ _ <br />PROJECT ADDRESS <br />L� 1 `� <br />,::.�- � <w'. <=�i <br />Owner <br />Tenant <br />G%a , i+-GZ-'� <br />Elecirical Contractor <br />Slate License Number <br />�-�-T �' <br />Proposed Use of Building <br />/�� /� -� c�-c-c� c� <br />h1ail Address <br />Mail Address <br />Mail Address <br />Square Footage (If residential new construction, remodel or addi:ien) <br />� <br />Number of devices (If low voltage) <br />/�-i� ���� L(�,�i � <br />City <br />Ciry <br />„�s.�.�a�s. <br />L�.�ti- I �4 S % <br />StatelZip <br />State/Zip <br />Slate/Zip <br />Conlract Price of Work <br />Conlact Person (Plan Review) <br />Description of Work lo Be Done: <br />C�Y"c.. �.Z / u-C cLC�V Li� GC rw.•c- G I <br />' CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily that I have read and examined this application and know the same to be tnie and <br />coRect All provisions of laws and orzlinances goveming this type of work will be completed <br />whether specified herein ornot. The g�anting o( � pe�nit does not presume to give authonty to <br />violate or cancel the provisions of any other state orlocallaw regulafing consWcfion or fhe <br />per/omiance of constructien. That 1 am auBionzed by the owner of this propeRy to perform the <br />work lor wfiich applicafion is made and 1 comply wilh the State Contractors Law 18.27 RCW and <br />296.200 WAC. . <br />�/�,��% ��-J ��/� ���� � <br />REVI55(J ]RC/IJ <br />Phone <br />Phone <br />Phone <br />FEE <br />�GJ� �'�' <br />PERMIT# <br />E ��c�-G�z�, <br />