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� <br />� <br />ELECTRICAL PERMiT APPLICAilOiN <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 />7 33 GR�tJ D /�vC_ <br />PROJECTADDRESS <br />�-�c�.�y� �e s 1 N � S-�1�� <br />Ovmer Mail Address Cdy SlalelLp Phone <br />7enant <br />Mail Address <br />�`�1 C�i ('tJ"��/ ��.-l�.0 � 1 Q l l' , C..° � 1 <br />ElectricalConiractor MailAddress <br />/�-f CC� Iti.EGoO� NT _ <br />Slate License Number <br />SF� _ <br />Propased Use of Building <br />300 � <br />Square Footage�(If residential new conslructian, remodel or addition) <br />Number of devices (If low voltage) <br />Cily <br />City <br />Descripfion of Work to Be Done: /e� � � 2� /�%f C�'��%�f <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 5105 <br />StalelZip <br />State2ip <br />Contract Price o( Work <br />Contact Person (Plan Review) <br />1 hereby cerii/y that I have read and examined this applicafion and know the same to 6a true and <br />correct. All provisions ol laws and ordinances goveming this type o/ woAc will be complefed <br />whefher specified herein or not. The granfing o/a permrt does not presume to give authoriry to <br />violate orcancel fhe provisions ol any otherstafe orlocallaw regulating consfrucfion or the <br />perlormance o/ construcfion. That 1 am aufhonzed Dy fhe owner �f Ihis propeRy to peAorm the <br />work lor which applicafion is made and 1 comply wifh fhe Sfafe .�ntrac�ors Law 18.27 RCW and <br />296.200 WAC. <br />Phone <br />Phone <br />FEE b� <br />�� � <br />PERMIT# <br />E � �a� - Z�(o <br />