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_ � — �----_ -- <br />ELECTRICAL PERMIT APPLI�;ATlON <br />CITY OF EVERETT PERMIT SERViGES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />33Z �Iv�a�i sa�n, Si-. <br />PROJECT ADDRESS <br />Tenanl <br />332 ti��,;su� �t�- �Y� <br />� Mail Address <br />Pdail Address <br />,� Co P,o. �ox� usl <br />Electrical CoMractor �dail Address <br />��vlzrEc.Sc�i Pw <br />State License Number (required) <br />2� ct���-��ul 1-4�v� <br />Proposed Use of Building <br />( � vo <br />Square Foolage Qf residential new conslruction, remodel or addition) <br />Number of devices (If low voltage) <br />Ciry <br />Cit� <br />City <br />� ISo3�OgZ <br />3 —i� - i 5 <br />c��1, q� Z� � <br />Slale/Zip <br />State2ip <br />Ue�� �, f� <br />��a - 8 vo- <br />Phone <br />Phone <br />�'Z `% <br />S�ate/zip 31p0 3'14 P�( 4(v <br />o�yo��, <br />Cily o( Everett 9usiness License Number (required) <br />'7 s�v. o� <br />CoNract P��k <br />c���;� �U�,-� �3�0� 399-(nl9G� <br />Conlact Person/Contact Numbed mail <br />Description of Work �o Be Done: 1<�P� `t'e � vU S�, ����UC2 �O � � ��/ 1��-- <br />w i-i'l� �Wtj J hS�4all In�EW �u� gawe-� iv� /�efGc Hro( c,a.� n� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I he�eby certi(y fhat 1 have read and examined this applicalion and know the same to be true and <br />conect. AI! provisions o/laws and ordinances goveming this type o/�vork wilf be complefed <br />w�hether specified herein ornoL The granting ol a permif does not presume (o give authonty to <br />violate or cancel (he provisi�:is o/any ofherstafe or local law regulafing consWction or fhe <br />performance olconsWclion. Ttiaf I am au(honzed by fhe owner oI this propeRy to perfonn the <br />�a�ork !or which applica(ion is made and 1 comply with Ihe State Contractors Law 18.27 RCW and <br />296.200 WAC <br />RfVI5E00P/O6/101< <br />FEE <br />� � 00 <br />P�RMIi# <br />E ��o3-o�z <br />