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ELECTRICAL PERMIT APF�LIG�TION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8870 - FAX 425-257-8857 — www.everettwa.org <br />� '��� �.� ��\b�. <br />PROJECT ADDRESS <br />a_,a�,� � <br />�,soa.�� <br />`Q. u M �,.�.`�-�av, Z E 7 o L� t 1 ��.. '�< Tve:-e'4-F .�v :tqZ � S� E <br />Ownef Mail Address City StatelZip Phone <br />Tenant <br />Contrector <br />L.��C�e�`1`�- � 42 <br />State License Number (required) <br />Proposed Use of 8wlding <br />�dail Address <br />Matl Address <br />City <br />Ciry a <br />��N(nuJeo�` t:aJ� <br />Square Footage Qf residential new construction, remodel or addd�on) <br />Number of devices (If low vollage) <br />Description of Work to Be Done \'(�w.Q � ����^ti-�- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />SlatelLp Phone <br />1��, #w3 y� �3�.�y�s <br />Stalel i Phone <br />� `�cx� �" <br />Ciry of Everett Business License Number (required) <br />/ ss�. �� <br />Conhact Price of Work <br />K�G ,Q�u�..,s t�7� 030-3�=/� <br />Contact PersonlContact Number/Emad <br />K�C;i,,,�a�--•s (�:..��e(-tc�{�r�cS.c� <br />1 hereby certdy th2t I have read and examinetl this appOca6on and know the same to Ge frue and <br />correct All provisions o/ laws and ordinances governing this type o� work wdl be completed <br />�vhe(her speciTed hcrem or nof The granhng ol a permd does not presume fo give authonry (o <br />wolate or cancel (he provisions ol any other sfafe or local !aw regulafing conslruction or the <br />peAomiance o/ construcfion That 1 am authonzed by fhe o�vner ol Ihis propeRy fo peAorm fhe <br />�vork �or which apphcafion is made and 1 comply wdh fhe S(ate Contracfors Law 78 27 RC W and <br />296200 WAC / <br />/C/ - ' �v �/ Z�/O�/ S <br />RE�95EU 08DYOIJ <br />FEE <br />75 0� <br />PERMITx <br />E 1502- OZ� <br />