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—�--- --- --•- - <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVEKETT PERMIT SERVICES <br />3200 CEDAR STREF.T, E`✓ERE'�T, WA 98201 <br />425-?.57-8810 - FAX 425-257-8857 - w�w�.everettwa.org <br />� 2J/a � rrY�,%'�t _ �T� � 1�ac✓ <br />PROJECT ADDRESS <br />�� '� ����u� <br />',, �,�L{/l�P�Ci� �a��l�'1��� ' — Statel2i Pnone <br />'�, Cwner t�talAtlaress ���Y P <br />Tenanl <br />P.tad Address <br />�'�S� SC!/ <br />Electncal Coniractor <br />61ad Address <br />/�v r� r o F a: I�3 l�Q.' <br />Stale Llcense Number (required) <br />Proposed Use of Buildmg <br />Sq��are Footage Q( res�deNial new conslruct�oq remodel or addition) <br />Nu��ber of devices (tl lor� voltage) <br />Description of Work to Be Done� <br />� �/`���� <br />CITY OF EVERETT LOCAL SALES Tn% CODE IS 3105 <br />City <br />Crty <br />Stale/Z�p <br />Slate�Zm <br />Phone <br />P�cne <br />� 2 �� 9,� i <br />City o( Everett Dusmess License Number (reqw�ed) � <br />n I <br />3�� <br />Contract Price o( Work i, <br />�Q,_ �n`�D-�,� Ca �- c�� GJ c-o r� �usfp�,�- <br />Coroacl PEySon/Contacl Num edEmad <br />� <br />1 he�eby cerfify Iha( I Irave �ead and examined fl��s applicafion and kno�v fhe same fo be true and <br />co�recL FlII p�ovisrons o/ la�vs and ordirrances govemmg this fype o! u�ork wdl be comp/eted <br />�vhefher speci(ed herem oi noL The granting ol a permit does nof presume to grve au(hority to <br />v�olafe or cancel !he provisions ol any ofher state or local la�v �egulafin9 consfn�chon or the <br />perfonnance o(construcfwn. Thal l am authorized by fhe oivner o( fhrs properiy fo pe�form the <br />�ti�ork lor e✓hich applicaGon is made and I comply �wth fhe Stafe Confractors Law 18.27 RCW and <br />296 200 WAC. <br />Itf 11S`:� C `=c: J; � <br />�/v v <br />FFE <br />�� <br />�0 � <br />PERMfrk <br />E I `4��Z- 1�3 <br />