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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />;`7� ��� r''G �r� /FfP <br />PROJECT ADDRESS <br />�,�,✓/� �Z,SZ�� <br />Owner _� Mail Address <br />Tenant <br />Mail Address <br />L��/�� <br />City <br />Cdy <br />� -ia-�3 <br />Ew i 3 o7-QO 3 <br />Cc,l/� 9�Za/ <br />Stale/Zip ��� Phone <br />�v�, <br />State/Lp Phone <br />�"Y u��� e�-�Y `�L `f 7 � Z Z�f �' �t,p /� �Gn. }� ii. �� /�,� }a'2.fL r/�.�g�C�SS' <br />EIe�IContractor MailAddress Cdy Slatc/Zip Phone <br />�-�°r7e i c7 �{��� <br />S�ate License Number <br />Proposed Use of Bullding <br />Square Foolage (II residenlial new construclion, remodel or addilion) <br />Number of devices Q( low vol�age) <br />�)/ ,// � <br />Description o( Work lo De Donc i'`�'� r�` r 5 �/ <br />au <br />Conlrac� Work <br />Contacl Person (Plan Reviev+) <br />� ,�`�i� � �� � S� � <br />CJ�J `�l`f �S - y`C,c'�% �f/n G7`�Jor �GX <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 herehy certdy fhat I have read and examined Ihis applicafion and knoiv !he same fo 6e (n�e and <br />conecL All pro��isions ollaws and ordinances goveminy fhis lyp� oI worN will6e completed <br />whether sper.i/in.d herein or not. Ihe granfing ol a pe�mit does nol pmsumr. (o give au(honly fo <br />violafe or cancr,l Ihe pr ions ul any olhrr s(ale or local law ingula(ing conslniclion or the <br />pr.rfornrance ol cor t u Uo i. T h 1 I am aulhonzed by the owner ol Ihis proper7y lo peifomr Ihe <br />work lor whrr.h plr �or �s m e nnd I comply wi(h Ihe Sfafe Conhaclors Law f A27 RCW and <br />796.200 WlU,��� � � � .•. <br />' ( � <br />rer visen v�oin <br />Fe[ - <br />�� <br />I--- — <br />P[RMIT# <br />EjNi�o�-_003 <br />