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---- - <br />_ -- ---- - --- � <br />ELECTRICAL PERMIT APPLICATOOIV <br />CITY OF tuERETT PERNIIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-88'0 - FAX 425-2b7-8857 – wewd everettwa.org <br />!� Z TZ V <br />� -r�- �O�I(" �-�JE Vb%�"T <br />� PROJECT ADDRESS � <br />' S�o7;��� f��� �.sr�+r� �u��T" 4Z� zsz .��o� <br />IOv+ner tda�lACdress City Slate!Z�p Phone <br />fl�� <br />Tenant <br />vG/za-rU rr� <br />[lectrical Conlractor <br />�4G� 1�i <br />P,1a��1 ACdress <br />Mal Address <br />Gty <br />�o i�x Z9� Gve���7T <br />G).;�.;a-� c��a��r��ZB� GG <br />State .�cense Number (requiredj <br />clevalU� �GOM - p�,<q qaruq� <br />Proposed Use o( E3utlding <br />G;y <br />Siate�7_�a <br />StaterLp <br />Pnone <br />_� �io <br />Pncne <br />Cily of Everett Busmess License Number (required) <br />4� `o <br />Coniract Pr�ce of Work <br />%��� `��zs �� ��5�� <br />Square Footage (If residenUal new construction, remodel or adddion) Conlacl Peison/Conlact NumbedEmail <br />Number of devices Qf low voltage) i <br />Uescrip6on of Work to Be Done: ��L (�UL�7L �/,�.O.U.C.�G�(.,�bZGGC/�T �'� <br />' FE[ -- ----- <br />� CiTY OF EVERETT LOCAL SALES TAX CODE IS 7105 r.l..y� <br />i �T <br />� I hereby certi(y that I have read and examined lhis applicafion and knmv the same fo be fiue and __ __ <br />conecf All provisions o�/la�vs and o�dinances 4oveming Ihis type ol �vork �rill be comple(ed — <br />whether speci(ed herein or not. The granling o/n pennd does not presume !o give aufhonty fo pERhllT'% <br />violafe or cancel the provisions ol any ofher sfa(e or local la�v regulating construction or the ' I <br />perlormance ol cons(ruction. That 1 am aufhonzed by 1he o�vner ol this praperty lo perfonn the E I� ( O� O� I <br />wo�k lor �vhrch applicalion is made and 1 comply n-ilf� fhe S(ate Conf�ac(ors Ww 18 27 RCW and <br />� 290 200 WAC. , , � ; <br />�« <br />:��-_...� . <br />