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r. <br />F_LECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FA;< 425-257-8857 — www.everettwa.org <br />� ,� ���a�� D�— <br />PROJECT AD�RESS <br />Owner <br />Tenanl <br />Mail <br />Mail AdGress <br />Ciry <br />City <br />SlatelZip <br />State/Zip <br />�—��—�3 <br />C—�30�—�`� <br />Phone <br />Phone <br />�.. ,�..i t=•.LYcM.IL 4� s' � i� .,�• u�,t.u� u.r_ �.A '=i9 � �12s Z'�`{ s�i i <br />Eleclrical Conlracior <br />Mail Address Ciry Slate/Zip Phone <br />� � T� �- r �7 � y�P � <br />Slate License Number <br />Proposed Use at Building <br />Square Footage (If residenlial new conslruction, remodel or addition) <br />Number of devices (If low vol�age) <br />££7� <br />Contiact Price of Work <br />I�•-l�� k��-rZ £�1�-- <br />Contact Person (Pian Review) <br />Description o( Work to Be Done: �Z��. e' �"�` �'�' �-Q��G� ' rT �� ��w VN� — <br />i✓r � r�1S� �bC' �Y�C. i�� E-�m tt���� — <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />1 Der�by cerfi/y fhat I have read and examined fhis application and know Ihe same to be true and <br />co�rocL All provisions o(la�vs and ortiinances goveming thrs type o/work will bo completed <br />itihelherspeci�ed herein ornot The granfing ol a pennit does nol prasimie fo give authonfy to <br />violate orcancel the provisions o(any ether state orlocal la�v regulating consfnicfion or the <br />pe�fom�ance ol constnic!ion. That 1 am aufho�ized by Ihe owner o(this properiy fo perlomi the <br />wo�lc for which application is rnude and I comply ivith the Slate Confractors Law 18.27 RCW and <br />296.200 WAC. <br />re. iseu v.�\a n <br />FEE <br />���j uG <br />PERMIT# <br />E ( �3� �� " � `�`f <br />