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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.gov <br />6 i�'� - �l ' <br />`�05 ���..�o A�v- /D ..���5 <br />PROJECT ADDRESS <br />J ul�..t � J � f� �,, so �`�`� �✓A ��f' ��-,�. L.i-c,-.c,Z� wv}- rtd'.�u �, Nd.S3� %- 77�9 <br />Owner h'�aJ AAdress C�ry Sta;rl2ip Pncr.e '� <br />Tenant <br />Mai Ad�ross <br />�.ly <br />State/Zip <br />Phc�e <br />I � �A �c'h. �� er��C %c7U`( (du}` r�,,e /�C I�c�t�no�o' w�- �'o...�v c{a-J'�iJ=�7�'% <br />Eleclncal CoNra��or h+ai Address Cdy StatcLD Phene <br />Cr r� O t"� ,� c{ 7- G�^^ [/ <br />Slate License Number (repwred) <br />I Proposed Use of Au�ldmg <br />Square Footage (If residenl�al new consiruction, remodel or addition� <br />Number of devices Qf low vollage) <br />Descnption ol Work m Be Done' <br />��.Li�i C� <br />d4-f"t+2uow. �lPiow�c-C- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ciry of L=vcrett f3usmess License Number (requ�red) <br />Coniract Pnce o' Work <br />.Y "1 i k� L r ti h��+..� <br />GonWct PersoNConWcl NumbedC-mad <br />1 hereby ceNty thaf I have read and exarmned fh�s apphcafion and know fhe same fo be frue anA <br />conecL All provisions ollaws and ordinances governing Ihis (ype o! w�rk will be compleled <br />wNefher sper.r/ied herein or nof. 7he granfing o! a permrt does nol presumc !o g�vr, aufhonty lo <br />viol�te or cancel the prowsions o/ any ofher stafe or local law rr.yulafing r.nnstniehon or thc <br />pedom�ance ol consWction. Thaf 1 am authorizeAby fhe o�vner o/ this property fo peAorm the <br />woiir lor which application �s matle and 1 comply wrth fhe Stafe Confracfors L'uw f8.27 RCV✓ and <br />296.200 W�C. <br />, <br />ignaWre <br />i <br />; <br />kt„�sE����r,�.—o„ <br />L_-- --------_ <br />� °��� �is <br />FEE <br />�'l�, °� <br />PERMTTx <br />El 51 L� �?.��1 <br />