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Nov 05 1302.34p Bartlett Eiecllia lnc. <br />360-579-1757 p.1 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.evere�ttJw�.org5�_��S y <br />back ��r`�ni`�. q- cct�„� � � i <br />rNo�'• Pleo ��E�. �y;ri��i`f- �'� �' h�� �,t��+�lti, V �5,�1- ca. , <br />�� �' �t�a41 <br />,�. � � � �l�r� �'���r,�-�", �.�' <br />PROJECTADDRESS � I��� � <br />l.� <br />.r�' �,� C�vl�-i�'uC'a�� �ib�•_.%l�./ <br />Owner ntai� aress C�0' <br />Tenant Mail Adaress ��N <br />Eleclrical Contractor Mail <br />Ii/� r2TL f��K o� 0 0�-i <br />State License Number <br />An1' 15l l� <br />Proposed Use f Building <br />r <br />�oo a <br />Square Foolage Qf residenlial new consWUioq remodel or aCdition) <br />Number of devices (11 low vollage) <br />DescriFtion of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />S:ate/Zip Phane <br />���.��353��7a� <br />SlatelZip <br />Phone <br />—� State2ip Phone <br />� ya5�3a7-3��t3 <br />ntract Price of WorR <br />Contact Person (Plan Review) <br />1 hemby ceRifylhat 1 have read ar�d exammed this applicution and lurow tbe same to be tme antl <br />comect. AI! provisions of laws and orclinances goveming tJris f�pe of work �r�ll 6e conrpfeted <br />whether speci(ed Ircrcin ornot. The granting ot a permif docs not prrsiimc lo give au�honty 10 <br />violafe or cancef 1he provisions of any other sfafe orlocal !aw regulating cor.sfructron or (he <br />perlamance ot constrvcfrori. Tha! I arn authon.ed by !be ownero(this p�operty to peAomi N�e <br />�vork (or whrcb application is made aad 1 conrpty �+�i[h the Stato Conlractors Law 1827 RCW and <br />296200 WAC. i <br />�:v.�,Y.�`�" �-icr�-.s� � <br />�,,�«� �-�„_, <br />D�� �� <br />� <br />FEE <br />�d.va <br />PERMIT:f <br />EI�I�I(�oDz <br />