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-- - -- �-- - -- <br />-�- <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETi, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - vrv✓w everettwa org <br />���—f���� ��. <br />PROJECT ADDRESS <br />�12 <br />Owner <br />Tenant <br />clectncal Coniractor <br />f�-cY�r�i (� M K <br />S�e L¢ense Number (required) <br />Proposed Use ol Bw!a�ng <br />blatl ACtlress <br />1;,ali AOdiess <br />�� <br />NaU Atltlress <br />� Square Footage (I( res�denbal ne�v construcUon, remodel or addAion) <br />Number of dewces Qf bw voltage) <br />I DCStnp��on O( WOrk �o BC Ornir_ �e�NYI_�'�-���— <br />I <br />CITY OF [VERETT LOCAL SALES TAX CODE IS 3705 <br />=V <br />crty <br />Gty <br />�ICI <br />Ccy <br />SlatelLp <br />Statedip <br />State�Z�o <br />Phone <br />Phorc <br />Pncne <br />��K�5�3 <br />City of Evere11 �usiness L�cense Number (reqwred) <br />� � �x� • <br />Contract Pnce oi'Nork <br />r.�1,��r �-5 ��.� �z��c.� r��3� _ <br />Contacl PersonlContacl NumbeuEmail <br />I hereby certrly (haf ! have �ead and Ctammed fhrs appl�caAa� end Fno�. the same fo 5e huC und <br />conecf All prowsrans o/laws .inU ord�nances govem�nq Ihis fype ol �voM ivdl be completed <br />n�hether spealied he�ein or nol The 9�anGng o/ a pennd dor, s not presurne lo grvc au(honty fo <br />vrolate o� cancel the piovisions ol any otber slate or local law rr.gulaung construction or fhe <br />perfonnance o! consf�uclion Thal 1 �m authonred by fhe o�vner of fh�s p�operty to peAorm fhe <br />n-ork /or r.hich applicahon is made and 1 comp/y tvdh fhe Stafe Contracfors Lar: 18 27 RCW anU <br />296 200 WAC <br />� .,t� // _ ;,/�-/�� <br />FEE -- -- � <br />� � O/ -� <br />PERh1IT.�+ <br />E(�((1-OS( <br />