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ELECTRICAL PERMIT A�PLICA'TION <br />CITY OF EVERETI" PERMIT SERVICES <br />3200 CEDAK STREET, EVERE?T, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - w�' co w.e ��r-�L�'1 i✓a - Jp ✓ <br />eh.� � f. L�e;e'��£v5 � G✓�+'Lf'i G�Jd- •�r✓ <br />.J <br />�1 ., r, C- l S /0 �l '�i <br />/ L 5 L� � D� r� iD- ai�i s <br />PROJECT ADDRESS <br />�I-f �.1 ('c ty>�c I 'i'�I� <br />Ovmer �dall nddrus <br />C��;.,N�?v�Ew l-�l, i 5. <br />Tenanl 1.fail Add:ess <br />C�bIL�'Tr �—>1 �� � ZJ � <br />C�ty <br />City <br />Slate/Zip <br />$l��C�[I� <br />Phane <br />Phone <br />���ct�v.U�r tl,cZ���G Fb UaX i��� �L�P-t�wa�..� LJn. `1�i,�C'�3 ��rZi)�Z2�2o�2 <br />Electrical Con(ractor Mail P.ddress Cily State2ip Phone <br />�r�- ��u�Ez 3������ ����y <br />State Ucense Number (required) Ciry cf Everett Business License Number (required) <br />f`�Gf�;',:i-rl;,�,vTj � %i5� . �i <br />Proposed Use of Buddmg Coniracl Pnce of Work <br />Square Footage Qf residenlial new cons(ruction, remadel or addition) <br />•___---- <br />Number of devices pf Icw vollage) <br />�'�. C'1tiS.P-nnl rsc-hw9a�•n.���v,.���Ntc,t <br />Contact PersoNContact NumbedEmail <br />Description of Work lo Be �one: (�Sn'Eii�� f?"�' "�- (�y SRV iN L �,�-('u�u}MET,-� 6� li(,r17-S � <br />���Ti� FnNS � Rro�Ge K-��)S � Z Gi2�u ii S <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hcieby ce�tily that 1 have mad and examined fhis applica�ion and knmv �he same fo be (rue ard <br />coirecf. A/l p�ovisions of laws and wdinanees goveming th,is type o/ worfc will be wmplefed <br />�vhetherspecified hemin ornoL The granfing ol a pe/mi( does nat presurne fo give authonty ro <br />viola(e or cancel the pmvisions o/ any othe� state or /ocaf la w iegulaling construction or fhe <br />peAormance oI construclion. Thaf 1 am aufhonzed by the a�mer of thls property lo perform the <br />work lor which applicafion is made and 1 comply with fhe State Con(rac�ors La�v 1827 RCW and <br />296.200 WAC. <br />N�„_��st__�,: 3,��_� —rz� L r�tr-I <br />FEE <br />� 5 D, °°' <br />PERMIT;t <br />EI�IO�I�U <br />