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� <br />U <br />ELECTRICAL PERIVIIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EV[RETT, WA 98201 <br />425-257-8810 - FAX425-257-Sa57—www.everettwa.org <br />"� i 1 �.o cu s � s-� _ <br />PROJECT ADD�:ESS <br />t� �a � ��_� i 5�� 7 <br />Ocmer htaii add:ess <br />G(u,�!�i�U E�w 1/�: i 5. <br />Tenant Mail Address <br />C�nu'�T <br />City <br />Ciry <br />6 -ID-�S <br />�I 50�6-0 55 <br />LJw `j �G Za f <br />Staie/Zip <br />State2ip <br />Phane <br />Phone <br />l�U:Dv.�:i� �l,cZ��C: �b %�ajr `j��� ��I'-��iaN� 1�4. `I�'ileE'3 (yZi)6�1z-zo�Z <br />Electrical ContraClor Mall Address City Stale/Zip Phone <br />t�'�''-c���e Z 3�'� i,�i <br />Stalz License Number (required) <br />;'J Qi� (^-%i�1'1A.t�+ 1� <br />Proposed Use of Building <br />Square <br />�—� <br />residential new construction, remodel or addilion) <br />Number of dev�ces Qf low voltage) <br />����y <br />City of Everett Business License Number (required) <br />� <br />Conlract Pric� of Work <br />TS G~�v�S:�-Anl rsc-nwnw�+2�.�v,,;�,nu,t <br />Conlaci PersoNContact NumbedEmail <br />Description of Work to Be Done: �%S�rnL (��E'�'1;{, y S�i'J i rI � (�-('ua��1M(�7v�- !,� �t(,�ITS � <br />�.�1'n-{ Fn -� �� P-n v G� K�o> S, Z��w �`�-S -- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceRify that I have read and examined this application and kno�v (he same (o be true and <br />rorrect All provisions o/larvs and ordinances governing fhis typc ol �vork �vill be complefed <br />r�hether specilled hemin o�noL The g�anting ol a permit does not presume fo give aufho�ity to <br />violafe or cancel the provisions ol any other state or focal lan� regulating construction or the <br />pe�formance o/consfrucfioa That 1 am aufhorized by the omner o/ this p�operty fo perform the <br />n�ork /or tvhich application is made and ! comply wilh the Sfale Confractors Law 18.27 RCW and <br />296.200 WAC. <br />OG <br />�<<-�seo �=,�:�o,�, r3 r� � C. � L" (-1 <br />�EE <br />�� <br />PERMIT# <br />E i50�-o.ss <br />