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� <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STR[ET, EVEP.ETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />��{(� �}(1,i�d�,�OYI l��l lMl�" �J ���Y2�: W('•l, <br />PROJECT ADDRESS <br />Tenant <br />� Mail Address <br />[1 S�,bor de Cl�il�aul�qvl <br />s�e g <br />Electrical <br />Mail Adc <br />p�rrnl+ �� �eHu <br />Mail Address <br />�Q � 1'1-. ��11 0 3°� <br />Stale License Number <br />ovvn� <br />Gly <br />i ,�.e,r�-� <br />Cily <br />Tenant- � <br />P, ,r�o.�-} <br />City <br />�,�? S��CLl1YC(,i2�- — <br />Proposed U Foes Building <br />S�uare Footage Qf residential new construclion, remodel or addilion) <br />Nwnber ol devices Qf tow vollage) <br />3-17�1(� <br />C I kD 3—D� 3 <br />State/Zip <br />Stale/Zip <br />1ef4� <br />SlatelZip <br />� I <br />Conlract Piice of Work <br />Contad Person (Plan Review) <br />��z 9� <br />Phone <br />31- I <br />Phone <br />��l <br />Phone <br />Description of Wo�k to �c Done�, L,�,�,1�,1i�LlW_ � ��C.�' LL � l-ld.L � �_IJ�—� �.`—' i—' "''--�— <br />=��—�1�-�C�- -��1_V-�l�Y_I�'Pi_Y� . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS a105 <br />1 hmeby cerirly tha� f have read and examined (his application anJ knniv Ihe same fo be liue and <br />conecL All p�ovisions o/laws and oi�lin��nces goveming Ihis typr, ol worl< vnll be comple(ed <br />whelher specilied hcrein or noL The gran(iny ol a pemiit does nol presurne (o give aufhonty fo <br />violafe o� cancel the provisions of any other sfate or local laro regulating conshucfion or fhe <br />perfonnance ol cnnslnicliorr. Thaf I am authonzed by fhe or nerol fhis properiy fo peAorm fbe <br />work /or whicb applicalion is made and ! cornply wilh Ihc SGife Contracfors Law 18.27 RC W nnd <br />296200 WAC. <br />FFF <br />�g5o <br />P[RMIT£I <br />El�-}�3 — 0? � <br />