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I <br /> ELECTRICAL P�RMIT APPLICAT'ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CF.DAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> G-la�-�� <br /> C—�o�.Sn�-�'�''1 <br /> 2yu P�N . cr ;-,,eti� q�z�,i uN� T� <br /> PROJECT ADDRESS <br /> �.au k c��'dS S11b VieW Or �tA.�, ,�.l� t.�A 922�J 41�-7�iW .o��7 <br /> Owner MailAddress City Slate2ip Phonc <br /> Tenant Mail Address City State/Zip Phone <br /> nu►��er - <br /> EleclricalContraclof MailAddrcss City Stale2ip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(It residenlial new construclion, remodel or addition) Conlact Person/Conlact NumberlEmail <br /> Number of devices (If low vollage) <br /> Description of Work to Be Done: _��5���_E,�r �. c�. �o h Cctrcn� �co be G��^ ^cc�+�` • <br /> FFE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � D � <br /> I hereby cerlily fhat I havc read and examined this applicafron and know the same(a be frue and <br /> correcf. All provisions of laws and ordinances yoveming fhis type ol work will be wrnplefed <br /> whelherspcci(ed hcrcin or nol. The�rantin�ol a pemiit dor,s nof proswne fo givc aulhonty fo PERMII JI <br /> violate or cancel fhe provisions o/any ofher state orlocallaw regulalin9 conslrucfion orfhe � � ��0� O <br /> perfomiancr, ol consfruclion. Thaf 1 am aufhorized by the ownero!fhis pmperfy fa pe�form!he <br /> �vork far�ti•hich applicnlion is madc and!comply wifh Ihe Sfatc Conlncfors law 18.27 RCW and — <br /> 296.200 WAC. <br /> � � /S <br /> i9naWrc �D�� � <br /> Rf:VI51i009Nf✓1011 _ <br />