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n <br />u <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET. EVERETT, WA 98201 <br />425-257-8810 - rAX 425-257-8857 — v✓�vw everettwa org <br />27G U <br />-��-- �ov7" �� �vb�-� <br />PROJECTADDRESS <br />S'�p7/��L �C��L �j%4%E t%l/� �ZS Z.SZ �'�O(� <br />C�vner lda�lAddress City Sla'e!7_p Fhonc <br />l / <br />Tanant <br />IAad Address <br />C !y <br />5'atc�L p <br />Pyone <br />� <br />c��a-�v,� Gr-��'�c >'a ,�x z9cn __cve���r-t- -----2�z_-�9•'_�, <br />Glec'ricalContractor L1adAdoress CiP; Stab^:L; P�ore <br />i��.� c�✓a�� re � �8� � � <br />IState L�cense Number (reqwrzd) City of Everelt Business License Number (iequired) <br />�� �o <br />c.levatu� roorn - nk� aa�ci�� --- — — <br />P�oposed Use of E3udd�ng ��� Contract Pnce of !^.b•k <br />,���7� �' •Z,-ri �� l �S,j� <br />Sq�are Foolage Q( residential new. conslructio�, remodel or adddion) Contacl PersonlConlacl NumbedEmail <br />I <br />� iJum6ero(devicesQ(lov+vollage) <br />t <br />i>r.sr.nption of Work to 6e Done�. a/L �-��L�7L_ �/,�O�U�(.�G� �l/ZG�C/ � <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS J105 <br />I hcreby r.ert:ly 7h,�[ I have read and exammed this npphcahon and know flie sarne fo he fn�c and <br />�-or�e�t All provisions o/leu�s and ordinances gm�eming this type ol �vnrk n��ll be cornpleled <br />r:hether spec�fied herein or noL The granting o/a permd does nof pmsume !o grve authonty;o <br />�, iol�te or cancel !he pravis:ons o/ any other state or local la�v �egula6ng consiruction oi (he <br />pr.�fomiance o! consWchon. lhat I am aufhorized by Ihe o�vner o/ fhis properiy lo peAonn Ihe <br />r;ork 1or u-hir.h applicafion is rnade and 1 compty v.i(h the S(afe Con(racfors La�v 7827 RGW and <br />296 200 WAC. � ,- <br />�- <br />� - !O 8 / �' <br />� Signature Ua(e ^ <br />. .��i,-'� .. . <br />�PEE <br />� <br />I ,�- 53�- <br />PERMIT" <br />E I� l0 � O� I <br />