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EI�ECTRI��4L PERMIT APPLICATI�JN <br />CITY OF EVCRETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 – www.everettwa.org <br />�I� :� � ���� c� � s� � � <br />PROJECTADDRFSS <br />�C�`.C' <br />Owner <br />Tenant <br />Electrical <br />� y,��.Y�i�'�s <br />Mail Address <br />Mail Address <br />�3 �9,�v�Sl� 51A <br />Mail Addre,s <br />i ��nv c:c�. �`��� ��1� <br />State License Number <br />JC V Ci. C, g— <br />Propased Use of uilding <br />Square Footage (If residentiai new constructio;�, remodel or addition) <br />Num6er of devices (if low vollage) <br />Description of Work to Be Done: <br />CITY OF EV'cRETT LOCAL SALES TAX. CODE IS 3105 <br />City <br />City <br />3 �-g��3 <br />��303— i�% <br />�/T�r ��� S�. � S5 � % <br />C•) y 2s . 34U,�PS�/ <br />Slate/Zip Phone <br />��/. ��/_ 7 <br />City Slale/Zip - � Phone <br />� c �zT <br />- � s c� <br />Co trac(Price of Wor <br />Contact Ferson (Plan Review) <br />I here6y ce�fily that 1 have read and ramined Ihis applica:ion and know the same to be true and <br />correct Afl provisiQns o(laws and ora aances yoveming (his type of work will be complefed <br />whefherspeci6ed herein ornot T5; /ranting o/a pem�it does not presurne to give authority to <br />violale orcancel the provisions of ar,y other ctate orlocalla�v regWaling consWction or fhe <br />perfonnance o(construction. That I am authonzed by fhe owner o(this property to pe�form the <br />�.vork (or �vhich applicafion is made and 1 comply �vith the State Contracfors Lmv 18.27 RCW and <br />� <br />FEE <br />� �' . C)C� <br />PERMIT# <br />E ��c�3- I�� <br />FE:�cfiiJT:^�f3 <br />