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• � <br />ELECTRICAL PERii111T APPLICATION <br />CITY OF EVERETi PERMIT SERVICES <br />3200 CEDAR STREET, EVER[TT, WA 98201 <br />425-257-8810 - FAX425-257-8857—v�vw.everettwa.org <br />��J I � iAcusr ��r, <br />PROJECTADDRESS <br />t l-�;�1 i 0 R�:� I 4j�� ? <br />Owner Nail Address <br />Gi�WIlJi��i��ti �i 15. <br />Tenant blail Address <br />�ul�,�l,:l.:�i ��G1�121C. 1"G i�3j( `�� <br />GlectricalConlractot MailAddress <br />1!'�'�_�pti�t x 3C`� 1,�-1 <br />State License Number (required) <br />!�D�a�2�t�-r1i5 <br />Proposed Use of �uilding <br />E VL=l2,:`T� <br />City <br />City <br />�t 1'—if-t�oN) <br />City <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices Qf low voltage) <br />b_���i5 <br />[_�506-b��l <br />LJp� q � LJ � <br />Slate/Zip <br />Stale/Zip <br />LJn. °I �D�'3 <br />SlatelZip <br />L�"L� 61 � <br />Phone <br />Phone <br />li )EZZ-2u�2 <br />Phorie <br />City of Evereti Business License Number (required) <br />� <br />Conlract Price of Work <br />�J l.i�l��l� ISC�iYlO%M{G�IiL�C.1�1WL�N�1� <br />Contact Person/Contact NumbedEmail <br />Description of Work to Be Done: CCS�n1L �7�C�j,_z SAV Ir� � i(,�"(����c.<'lti�f7vj- uF- ��(�r�T:. � <br />�lA'T�{ Ff��S � P-l1vG� K�oD$ ���., i r5 <br />CITY OF EVEREiT LOCAL SALES TAX CODE IS 3105 <br />I heieby certdy thal I have read and examined lhis applicafion and kr.rv the same to be true and <br />correct All provisions o/ /aivs and ordinances goveming this type of �vodc n�ill be completed <br />r+hether specified herein ornot. The granling ol a permif does not presume to give aufhoiity lo <br />violate orcance! fhe provisions o! any other state orloca! la�v iegulating construcfion or the <br />performance o�cons�iuction. That I am authoiized by fhe oivner o! this property to perloim the <br />�vork Por n�hich application is mode and / comply �vilh the State Confractors La�� 18.27 RCW and <br />296.200 WAC. <br />OG <br />Reraeocs.oe:rou �j���L 'jj� � <br />FEE <br />� L U6 <br />J <br />PERh1IT/F <br />E 150(o-OS�i <br />