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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />200 CEDAR STREET EVERETT, WA 98201 <br />3 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />V �G�) /'� C�-� q vc (� �� � 7 <br />� �v <br />PROJECT ADDRESS� /� <br />C'��,� � � -- <br />Owner Mad l�ddress City <br />Tenanl <br />��s <br />Gleclrical Contraetor <br />Mail Address <br />/.�,� 7.3� <br />Mail Address <br />City <br />�s � -��� <br />�1-c,.r,� �=�0�3 `�"i� % <br />Slate L� ense Num6er (required) <br />� l�� <br />Proposed Use oi Building <br />��D � <br />Square Pootage p( iesid lial new construclion, remodei or addition) <br />Number of devices (II low voltage) <br />Descriplion of Work to �e Done� <br />Statc/Z�p <br />Phone <br />Slale/Zip Phonc <br />s����� <br />City Stalc�[ip � ^�"� <br />���-�a-y- a�DP <br />�� o� �-�e e���s ne�ss License Number (reqwred) <br />`__.S� t�-�/_!1 ' <br />Contracl Price ot Worh <br />�v - .���.� � <br />Conlacl Per on/Contacl Numhed[mad <br />.3�D 3�a-� �-� �' <br />L— �� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily Ihaf 1 have icad and exarnined fhis applicafion and know Ihe same fo be hue anA <br />conecl. All piovisions of laws and ordinr�nces ywr,min� Ihi.^, type ol �vork will Ge complekd <br />whefhr,r specilied Aerein or noC !he �ranfing o/ a P��'nil tloes nof p�esume fo givc aulhority fo <br />vioL�le anc�llheprovisionsolanyofherslafeorlocollawregulatingconsfrucfionorfhe <br />perl rm�nrc o consfrucfion. That 1 am aulhoiiir.d hy Ihe on'ner o/ lhi; n�o�e�ry ro n��i����� rne <br />w rk !or �vhich ipp���afion is rnadc and I n u'i!h thr, Sfafe Conhar.fo�s Law 78.27 RCW and <br />9G 200 WAC. � — — <br />-- � _ /��/ / � �/ C/� .� <br />FEl � — <br />gD �D <br />r�Erirtn o� <br />_E ��o�_-�z5 _ <br />iav�nrnco-oc,�niu "- - - <br />