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ELEC`TRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - u/ w uJ _e vc���ti a�tt •�,p �/ <br />ea.�..� I�. Lv�irc-}-�e.ps � ever�t-y tr��...�3,� J <br />`� � �- a�- �5 <br />, [_ISo7_Ilz <br />� Zj I,u cti, sr <br />NROJECT ADDRESS <br />' ��� . <br />ov,ner <br />G��:,��r;v��w G�1 <br />�'� �S�X � 5`i 7 E�c-�t,G� 1,-�.N `j � Zo ( <br />Mall Address City 5(ale/Zlp Phone <br />Ten2nt �AallAtldresc City State2lp Phnne <br />f�cDwu'�r �I.�Z7fziC, Pe P;•aX `I3°! I�Gr—c��e>;.,� 6Jq. 1`��'$3 � <br />Eleclrical Coniraclor �/ Zs � Ei Z- 2u I Z <br />MailAddress Ci1y State/Zip Phone <br />l/��`.�Du�E� 3�� ��i �'?�C1y <br />Slale License Number (reqwred) Cdy of Everetl Business Llcense Number (required) <br />�cf�r�n�ti,.�-�s � Zsp <br />Proposed Use of Building Contract Pdce of 1Nork <br />Square Foolage (I( reslUentlal new conslrudion, remodel or addition) <br />Number of devices (Il low voltage) <br />Descriplion of Work to Be Done: �Gi�� <br />TS_�.�yuShS11J TS't'Ytito9Kiw2�2.niw4rvlt i <br />Contact PersuNContac! NumbedEmail <br />IN� <br />��'rN Fnr+s , Rn�G� K��ns � Ze.,,,� <br />—s <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hemby cerii/y fha� I havv read and examined Ih/s applicatlon ard kno�vlhe samc �o be truc and <br />conecf. All provlsions o!la�vs and ordinances goveming Oris (ype o/ work will be cornp/efed <br />whefher specllied horcin or noL The gian(Ing ol a permit daes nol p/v;umc lo give au(hodty to <br />violafe or cancel (he provislons of ony olher s(a(e or lowl la�i iegula(Ing conslnicf/on or tho <br />vo�k !or wh/ch application is made and 1 co(mplye�f� (he Sfate Conf a/c(os Lav� 18.27 RCW and <br />296::00 WAC. <br />OG <br />ncroscnour�cr,air �jr GC. <br />f.�iG;-I T"S <br />FEE <br />��V <br />�ear�rrar <br />E I5o7- I I �- <br />