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ELECTRICAL PERMIT APPLICATIOfV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - u/ cv uJ . c�'t-��� r:�4 . Jri > <br />e,l•n�1' c��r�-F-fePS ��c;V£�'G�'I Cdd� Jr.v <br />%Z7i t�Ir.�Dcn) <br />PROJECT ADDRESS <br />Ormer <br />'enant <br />�F�K1 PD 1��jc I'j`I ) <br />r; af�.'.dd�_r.. <br />C��:,N��v��w� c{��fi <br />!,ta.l na:;reca <br />C � c 1LaT� <br />G:q <br />C.t� <br />� �s;�- �`�9 <br />�G��I-15 <br />l,-;. `� �G L� I <br />StateJ7Jp <br />StdlnZp <br />Phon. <br />Ph�nc <br />h��l��:U�('-�k.Zi-1'-�[. Po UoF `i$�f l�!��°-t�t.su�.,� L.in. `l�i,'D��3 �yZs)iZ2�2c�"L <br />I cledncal Contractor hta�l Address C�ty Stalc/Zip Phonc <br />��'��' ��.��E �. 3ct ��r �v �, y <br />I State License Number (required) City of Everett Busin� s License Number (required) <br />j f'�Gp;%�TYii,r-,v'lS '� �J I�� �� <br />I Proposed Use of Budding Contracl Price ol Work <br />Square Foolage Qf resldenlial new constnicfion, remodel or additi�n) <br />tJumber of devices Qf low voltage) <br />�S C-Uszrnn� rsr-nwv.,�2� ,�w���:�,a <br />Contact Person'Contact NumbedEmail <br />Descrlption of Work to Be Done: _ ��S�11L/ L�7�i�(,'r yiV i r� � i�-�^HlU'M67vj- L� Li��-I�-S <br />F J <br />_ �n-rti u�rv> � r�,��t K��,�s -3 � ���, � rs <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fhat I have read and examined lhis applicafion and know the same :o be true ar.d <br />co�ect. All arovisions ol laws and ordinances goveming fhis type o/ worlr will be cempfefed <br />�vhether speci(ed hemin o� noL The granting ol a permit does not pmsume fo give authonty �o <br />violate or cancel the provisions o/ any o(her slate orloca/ law reyulafing construction or (he <br />pedomiance ol construction. Thaf ! am au(honzed by fhe o�vner ol fhis pmperty to peAoim fhe <br />work lor which epplrcation is made and I comply with the State Confracfors La•�v 18.27 RCW and <br />296.200 WAC. <br />rev;smcr.,_�:��., _ �j��LL _TO L �`{ii <br />FEE <br />�5�P�5 <br />PERMIT;? <br />E1�10-1�1�I � <br />