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ELECTRICAL PERAIIIT APPLICATION <br />ClTY nF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� <br />PROJECT ADDRESS <br />� L cr�SlruG�r�Ovl <br />Ormef MailAddress City Statc�Tip Phane <br />Tenant <br />Eledrical Contractor <br />Mail lldtlress <br />�/ o <br />Matl 1ldtlress <br />cl�l��zo��� <br />Stale License Number (required) <br />Proposed Use of Bwlding <br />Square Footage Qt residential new conslruction, remodel or addilion) <br />Numbcr o( devices (If low voltage) <br />Description ol Work lo Bc Donr. <br />CITY OF [VERETT LOCAL SALES TAX CODE IS 9105 <br />City <br />StatelLip <br />�hone <br />City StatclZ�p ����l;,zOho�� <br />/ <br />__`L--l�U � <br />City of [veretl Busmess License Number (required) <br />Contract Price of Work <br />Conlact Person/Conlact NumbedEmail <br />I hereby cc�idy that 1 havc ro�id and examined ll�is applir.alion and know Ihc samc (o bc lrur, ,vnd <br />r;nnect. 1111 provisions o/ laws and ordinanr,es goveming (hi: fype olwodc �vill be cornplefed <br />whefherspecdied herein ornoL Thr, ��rnn6n� ol a permil does notpresumr, lo give aufhonty fo <br />viola(e ar cancel fhe prowsions oI any other slalr, or local law regulating consfnrr.Gon or (hc <br />perlonnancr. ol construclion Tha( I arn authonred 6y fhe owncr of Uiis property to pmfonn Ihc <br />wort< lor v.�hir,h applicalion is made and I r.omply wi(h flte Sfefe Confraclors Latv 18.27 RCW and <br />29G 200 WAG � <br />. <br />/a-�3�/_ <br />� � ---- - <br />,,,��„o, oa�c <br />i�r wseo osr,e%o i+ <br />FE[ ------- — <br />�� � <br />PLRMIilt <br />E ,�fl 0--08"� <br />