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ELECTRIC�►L PERMIT APPLiCATION <br />CITY OF EVERETT PERMIT SERVICE� <br />3200 CEDAR STREET, EVERE'fT, WA 98201 <br />425-257-8810 - FAX 425-257-8B57 — www everettwa.org <br />7(}3 �,C�In,V`c•� IJr,J�. � 1_Ue1�el+ ��,a 9�a�� <br />PROJECT ADDRESS <br />Tenant <br />Ida�l AAdress <br />Meil ACdress <br />�Jr i �� L�(1nC�� <br />Gry <br />City <br />� -�o -14 <br />�lyo4-�l7 <br />Slate2ip <br />State2�p <br />8� <br />Phone <br />Phone <br />��.�.�.a Sow.,�� so1 s� 5 3 0� I�u�<<� Q� � N t,J S��l� W d ��� °� <br />�lectrical Conlractor Mail Adtlrvss City State2�p Pnone <br />f t,��.i�5s 1�.� r i,- <br />State License Number <br />Sr-R <br />PrcDosed Jsc o( Building <br />�� c�,��� <br />Square Footage (If residential new conswctan, remodel cr addition) <br />Number of devices (If �ow volta9e) <br />!:escription of Work to Be Done <br />S 1a-Sic.rv� 1,., . �� <br />'� <br />CITY OF EVERET f LOCAL SALES TAX CODE IS �105 <br />� ;�3,Sss. �� <br />Contraa Price of'JVork <br />Contad Person (Plan Review) <br />'-► ( k�-�� ����,,,,,i�; <br />I bereby certily thot I havo read and examined Ihis epp6cafion end know the same (o be (rve and <br />correct. A!I provisions of lews ond ordinances goveming fhis typo ol work will be completed <br />whelher spaci(ed horam or noL The granting ot a permif does nof pmsume fo give au(honty to <br />violalo or cance/ Ihe pmGisions ol arry olher stafa or local law rogula�ing construction or the <br />peAomrance ol consln%ion. Th�l�m authonzed by the o��ner ol this pioperty tv peAorm tbe <br />work for whic apphcFrfi n is made a d I comply with the Slafe Contracbrs Law 78.?7 RCW and <br />296 200 W � <br />�/� - � U - ��� <br />ae�ism i;eu <br />FEE <br />ci0 �� <br />PERMCf# <br />E i y-o �l - �+"I <br />