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ELECTRICAL F'ERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — v;ww.everettwa.org <br />3 � a �� c,�� d �� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />(� i e� 31 � <br />Mad Address <br />MadAddress <br />Ciry <br />City <br />State2ip <br />State/Zip <br />6_a�-i3 <br />��3 a s -i �� <br />Phone <br />Phone <br />_ ris �lecfvi� LLC �ake Si--e�e,v�S <br />Eletlrital ContraClor Mail Address City Stale2ip Phone <br />State License Number <br />S F(L <br />Proposed Use o( Building <br />, ��� <br />Square Footage QI residential new construction, remodel or addition) <br />Number o1 devices Qf low vollage) <br />Descnption of Wo� k to Be Done: <br />1 � �v �n � <br />�- <br />CI7Y OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />'l2 <br />� �j <br />CoNract Price o( Work <br />Contacl Person (Plan Revie�v) <br />1 hereby certily tfia! 1 have read and examined this applicatian and kno�v fhe same to Ge frue and <br />correcL All provrsions olla�vs and ordinances goveming fhis type o! worlc �vill be corripleted <br />�vhelher speci/ied herein or noL The granting ol a permit does not presunte to give aufhonty to <br />vio/afe orcancel fhe provisions of any otherstate orlocallaw regulating consWction or(he <br />pedomiance of construction. Thaf I am aufhonzed by fhe ovmerol fhis propeRy (o pedomi the <br />�vork /or n�hich applicaf/on is made and 1 comply wilh �i,a State Confracfors Law 18.27 RCW and <br />296200 WAC. <br />51�.�I1� <br />ae viseo �n,a-u <br />FEE <br />�v -oc� <br />PERMIT� <br />E i ��05 - I��' <br />