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ELECTRICAL PERMIY APPLICATION <br />CITY OF EVERETT PERMIT SFRVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8910 - FAX 425•257-8857 — www.everettwa.org <br />(��p 05 U�izp��r.1 12oA0 <br />PROJECT ADDRESS <br />Ekctrical Contracror <br />►tANSF'ciZ G.GOS <br />Mail MCrlte <br />�f�' �1� �� /J�I <br />Mad AOOress <br />S���n,���g_��o� <br />Mnll CAiees <br />!�R iFFs9►yMi <br />Slate license NumDer (reQuired) <br />ProposeE Use ol BuilCing <br />��X�� � <br />Squere Footage (II rcsidentiei new constructio�, rcmodei or addibon) <br />1 <br />NumDer of devicea pl low vonage) <br />DescriDtion ol WoAc to Be Done: <br />Ciry <br />C�ty <br />. �su iJ1- <br />Ctly <br />ZG�-2�1 W-2ao6 <br />i w � ��'Zo} <br />Sttle2lp Plqne <br />Stete2p <br />Cwa <br />SUIefLip <br />Phone <br />Pfqne <br />os3sz2 <br />City of Everetl Business Lianse NumDer (requircC) <br />�� 5��, o0 <br />CoMraet Pnce of Work �O �' n e,''� �� <br />S1 <br />�p �y � 0�21� <br />Contad PenonlConlad NumberlEma�l <br />J�►� L��►�►�►,2� sfc � R� <br />, co <br />l6 EJSfS/"�/n�Gt �jn: �i�12v� SVSitYV�, <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS ]105 <br />1 �zreDy ceRily fhaf I �ave read end eramiiretl this applicetion and krtow fhe same fo be (rue and <br />Correcf. All provisrons o/lews and ortlinances goveming this type ol work will De compfetBd <br />wnef�er speafreC herein or not T�e granfmg of a Fermit doas not presume lo give euthonry ro <br />violete or cuncel Ne provisions al eny ofher sfete or local lew regulefinp construction or the <br />peAormance o/consfn�ction TAaf 1 em aufAon:eO 6y fhe owner of this property fo perlorm tAe <br />work /or which applicafion is made and I comply wilh I�a Sfate Contrrcfors Law iB.27 RCW and <br />296.200 WAC.i� / / <br />/v� <br />���oo.�,. <br />//ZG�/5� <br />U <br />FEE <br />�� �0 <br />PERMTf# <br />E ( 50 � - ( Z°j <br />