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� <br /> ELECTRICAL PERMIT AP�LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —�nn^rw.everettwa.org � `�—�� <br /> C15�0/ -( l}� <br /> � � Ll � l2�-rn°I l� �-I�l� ��s <br /> PROJECTADDRESS <br /> � I L���' Cl,.�j�L � �2 L <br /> ��1' GUdi-TVf'(.��, � G-�' L�(/ G[l'I�l�/liI l�o2rl /G a � <br /> OWnef M1'ailAddress City StatelZip Phone <br /> Tenant Mail Address C�ty SlatelZip � 7 �Phone <br /> GJ <br /> �r�L ,�,!(">� ��--�' �� ��t" /Y'7� �// '�Q'� � Z��/ <br /> EleUrical Contraclor Mail Addmss City State2p Phone <br /> r l y11� �� ��v �� � <br /> Slate License Number(required) City of Everell Business License Num6er(reqwred) <br /> Proposed U�of Dui�g Contracl Price o(Work <br /> Square Foolage (If residenliai new conslruction, remodel or addi�ion) Contacl PersonlConlacl NumbedEmad <br /> Number ot devices Qf low voltage) <br /> Description of Work lo�e �one: �v��/����L _ _ —__ <br /> FF[ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �� � <br /> I hereby certrly thal I have read and examinr.d fl�is�ppficahon and know fhe same(o be lrue anJ <br /> conecf. All provisions o/I��ws and ordinances�ovenrrng Iliis lype ol work�vill be complefed <br /> whc(hcr specilicd l�c�ein or nol. The granting o!a permrl does no(presume fo give aufho�ity to p[RMITlf <br /> violate orconcel fAe provisions o/any olher sfafe or locallarv m�ufafing conshucfion or fhe � ��� � _ � �� <br /> peAormantc o!cons(�uclion. 7hat 1 am aufhonzed by fhe owncr o/fbis property fo perlonn Um <br /> tvork for vd�ich pplicafion is madc and I comply�vilb fhc Sfafe Confroctors Law 18.27 RCW and _ <br /> 796 200 W . <br /> Sign3lurC � DaIC � <br /> Rf-l9St(JOBICGRJIO <br />