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__ --- � — — • <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425•257-8857 — wwev.everettwa.org <br />� 3 � � � (�7%S(�/ S f <br />� <br />I PROJECT ADDRESS <br />5or.+� f' �'s � <br />Ovmer <br />Tenant <br />_ S <br />Electrical Contraclor <br />Ivtad Address <br />A1ad AAdress <br />htail Address <br />C1�I�1����3qk � <br />State Lice se Number (required) <br />Proposed Use ol Build�ng <br />3��7, , ` <br />c�ci <br />City <br />'T % S�" � <br />Square Footage Qf residential new consiruction, remodel or add�l;on) <br />Number ol tlevices (If low vol�age) <br />Slate�Zip <br />Stale/Z�p <br />P one <br />�� ��'a// <br />Phone <br />C�ty Sta�eiz�p y'L5:76a �o�e <br />� <br />�� �� <br />Cily o( Everett Business License Number (requued) <br />y�.od <br />Coniract Pnce of Work <br />��y cl�,� y'�� ��-_ 2g�_ <br />Contact Person/Contact umbed[ma�l <br />Description of Wark to Be Done: �� l�� �/�� GU�r f/ <br />!� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hmeby certily that I have read and examined lhis application and kno�v fhe same fo Ge frue and <br />correct All provisions ol/aws and ordinances goveming fhis type o/ work will be compfeted <br />u�hefher specrfied herem oi noL The qranfing o! a pemiit does nof presume fo give authonty ro <br />violate or cancel the provisions ol any ofher state or local W�v regulating constniction or Ihe <br />performsnce o/construction. 7hat 1 a;n aufhonzed 'oy Ihe o�vner ol fhis properfy fo peAonn Ihe <br />�vork for �vhich applicafion is made and I co�nply �•.rth the Sfate Confractors Lan� 18.27 RCW and <br />296200 WAC. <br />� <br />Fevrsco oao5x i+ <br />2_2 -�l� <br />F[E <br />5U �'' <br />PERr�rru <br />Ej�}IZ.- I�°� <br />