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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 />c���,�000 <br />4 5 I D ('� ra,-�ct �ve. �v�-re �-1 �3 �ad3 <br />PROJECT ADDRESS <br />Owf1Ef <br />Tenant <br />Mad Address <br />MdJ Atltlre55 <br />Cny <br />Gry <br />�,, �t �i x 2� 3 <br />Siatc2�p <br />State2 0 <br />�� � 3_, s <br />Phone <br />Phone <br />_-1 <br />=rec�, Eieclr�c ��oc� o cvr,- g�vd Ev��c�F �F W c� 9£s1o3 _ � <br />EIBCtnCal Cont�•ltlor �dail Atltlress Ciry State�2�p Pho�� i <br />R � �� �� f.Ut �C � - <br />State License Numher (reQwre�) <br />RQ 5 � d.��til, a.P <br />Proposed Use of BwlCing <br />�1a <br />Square Foolage (If residenlial new construchon, remodel or add�bonl <br />nj0. <br />Numbe o� devices (it iow voitage) <br />�'����/��-f{�� f ���2 `��42 <br />City of [Lerett E3us�ness License Number (reqwred� <br />�aa� 00 <br />comraa ar�cc crwonc <br />ICQ,n.�.,��of, 1 1'1 I <br />lL �r-� 1�LVn t� �� o. te»"� <br />Conlact PersoNCon'act umbedEmai <br />Descript�on of Work to Eie Done �t!� �� S V(. �.����J <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �705 <br />1 hereby cerhty Ihal I �ave read and eaarnmed this applrcafwn and kno�v the same to be fnie antl <br />correcl All prov�srons ol la�vs and o�dmances goveming (his type ol work wJl De completed <br />whefhar speahed herem oi nof The 9�anOng o! a perrnd Aacs nof preswne fo grve aufhonly fo <br />v�olafe or cancel fho prov�sions o� any ofher slafe or loc.al law regula6ny consUuc6on or fhe <br />peAonnance oI consl�ucf�on Tna! I am a�rthonzed by tha owner ol lhis property fo perfoim Ihe <br />wo�k for wh�ch app6cahon rs made and I cornply wqh fhe Sfafe Conl�acfors Law 19 27 RCl1' and <br />296 700 WAC <br />R=nsencses�u�+ <br />F[E <br />���0� <br />EPERP11Ta <br />���-� <br />