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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.org <br />—`�1 �— �I— 7� � 1`'i�av'J 111'� <br />PROJECT ADDRESS � <br />Owner <br />Tenant <br />Contractor <br />Mail Address <br />Meil �tltlress <br />�s�l(��.�(oC�d�1� <br />St�te License Number <br />� � �� <br />Proposed Use of Buitding <br />Atldress <br />S!.C� SC� f= i <br />Square Foolage (If residential new consiructioq remodel or addition) <br />^h�;nber a( devices Qf low vol�age) <br />Cily <br />City <br />�� ZZ _�3 <br />C i3�g--iUO <br />SlatelZip <br />Slalel2ip <br />�^ `/��� <br />Phone <br />Fhone <br />City StatelZip Phone <br />. ` <br />C nlract Price o( Work <br />.G�L�T �� <br />Contact Person (Plan Reviee+) <br />Oescripi;on of Woik 1� 13c Donc: � i.T�-{F--1v C' ��-'c J��N 1�, l l�"""�� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ce�tity fhaf I havc read and exarnined this applicaGon and kno�v Uie same fo be t�ue and <br />coriec(. All provrsions of laws and ortlinances yoveminy llus fypr, ol work wdl be compfelr.d <br />whc(her specdicd herein or noL The granting ol a pc�mit Uocs nof presume to qrvc aufho�ity fo <br />violate or cancel fhe p�ovisions ol any other stafe or focal la�v regulnting consfn�cfion or fhe <br />perlormance ol consfiuc(ion. Thal I am aulhorized by the o�vner ol this propeRy fo perlonn fhe <br />wo�k lor which ripplicarion is maUe and I conrply wilh fhe Sfafe Conhaclors Law 18.27 RCW and <br />�9G.200 NiAC. <br />� <br />Q <br />J�— c� 2Z (3 <br />— � .---...._ ,�� - — <br />,:��,s«��o,,, <br />FEE <br />P[RMI I 71 <br />E I 3a &--�� <br />� <br />