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� <br />� <br />ELECTRICAL PERMIT APPLICATION <br />670 7 <br />PROJECT ADDRESS <br />OwflOf <br />CITY OF EVERETT PERMIT SERVICES <br />320C CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www everettwa.org <br />ih'�D�So�✓ iZ0/Y� <br />cu��i�'F1f/ iNG. <br />MBd i�tltltC55 <br />�-0�--�3 <br />G— � �6 � �i7 <br />29i6 �'o'� Sf sc% ��r+r>� q�aoy <br />City SIa1MZip Phonc <br />UmdRq G/���Y <br />Tenant Mad Address Ciry Slalc2�p Phonc <br />NM����K. s��� c��� 12s5 v�rvfKf �NF• �� s�M1�E , w� q8�oq z�d-tll-oroo <br />Electncal ConVaClor Matl Addmss Gly Slalc2ip Phonc <br />/�Atlo5c�3�m 3 � 25'o�UO <br />Stale License Number Contracl Pnce of Work <br />Proposetl Use of Bwldmq <br />Square Footage Qf residenlial new conslruction, remodel or addilion) <br />Number of devices (Ii low voltage) <br />Conlact Person (Plan Review) <br />Oescripiian ol Work lo Be Done�. /Ni i�i� l uf�(• gw6�� ���� ��inr,i�q�Fp wA�l i(G`�• <br />�a,�Ncr1�.,J 7� S�c� c�%t�u�l <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />! hereby certdy lhaf i have rcad and cxamincd this app/icafion anU know fhe samc lo hc Wc anA <br />cormct. �ll provisions o/laws and ordinances goveming this typr, ol work wdl be cornpleted <br />whefher spec�fied hercin or n t. The granfing o/ a penmt does nnt pmsume M grve aufhonry ro <br />violafe or cancel fhe p visi s qI any ofher sfa(r, or local law rcyulaGng consfn�r.hon or fhe <br />peAomiance ol r.ons6 fior T1d'af I anr au(honzed by Ihe owncr o/ fhrs propeny fn perfonn fhe <br />work 7or wh�r.h apphc. on . rn5de and I comply wrfh Ihc SWtc Confrar.lors Law 7B.27 RGW and <br />296.200 WAC. � „ � <br />�� 2°'�3 <br />NFV6E0 t�JNU <br />FEE <br />�j0'OD <br />PERMIT# <br />E l �Db - 1�}�l <br />