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ELE��ICAL PERMIT AP�LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 982D1 <br />425-257-8810 - FAX 425-257-8857 — w,' c•r uJ -� �'�re;.:�•� :�.;. . �!7 :� <br />e�t-.,, � 1. ���.�,�++� ps V �ve-r�r`,` �:.��.�> ; <br />� <br />J <br />gG� ��;�, � <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />��F1 i o t;s�; � ��-�� <br />G�ail Address <br />Giu11"����CW� �.�I{��1 <br />�daRAtldress <br />�'��G^��:u�,'. �t,�[-�� iG (''t; r;�a X yg�� <br />Elec�rical Contractor fJail ACdreSs <br />I�'�' �b�;�t x 3c� vt <br />Slate Lir.ense Number (required) <br />fJ Gta ��:n1't.��.r i 5 <br />Proposed Use of Buildiny <br />��b6lL�l"� �,>., <br />v <br />Cily <br />Cily <br />l�� �'-� � <br />Ci�y <br />Square Foolage Qf residential new construc�ion, remodel or addition) <br />Number of devices (If low voltage) <br />Description ot Wark (o Be Done: ��CS <br />c�s�d��� � <br />6 —ab—i� <br />�% LZiI� <br />State/Zip <br />State2ip <br />Phor,e <br />Phone <br />� A . °'i ti� c �: 3 � <br />l,Zs-)Siz zoi2. <br />StalelZip Fhone <br />����`f <br />City o( Everetl Business License Number (required) <br />� <br />Contract Price of Work <br />�-Cyvatf.�nl T;Sc-�+wOKw�� n,,,����:,.,�;, <br />Contacl Person/Conlacl Number/Email <br />$ �9'J i N l: Il.el�u. <br />�r�'r� �-n,�s , i2�a:��c ti_vi)5 Z � � r.-�;�,,, �- <br />CITY OF EVERE'IT LOCAI SALES TAX CODE IS 9105 <br />I heieby certily that ! have iead and examined thrs applicatron and know (he same to be true and <br />correct. All provisions ollaivs and ordinances goveming this type ol work r:ill be comple(ed <br />�:hether specilied herein ar noL The granfing o(a peimif does not presume fo 9ive au(hority fo <br />v;�la(e o� r,ancel the n;ovisions ol any other s(ate or local /aw regulafing consVucfion or the <br />peAormance otconShucNon. Thaf I am authonzed by (he ownerol this property fo per/orm (he <br />�vork (o� �ti�hich applicatron is madc and I r.omply wilh the State Confractors La�v 18.27 RCW and <br />296.200 WAC. <br />OG <br />Rewseo oe�ocrzou � � � � ` � <br />L <br />FEE <br />�5 0, 6� <br />aeRnirr# <br />E �5��� l°i�l <br />