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� � <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9820? <br />• 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br />�O � �� 5o6—o6b <br />�-1i-�5 <br />�� �in�e- ,Sf. - <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Eiectrical <br />Mail Adtlress <br />I�tail Address <br />Ma�l <br />r��� s� � oy�l K6 <br />State License Number (required) <br />Proposed Use of Building <br />Square Foo�age Qf residenlial new consiruction, remodel or addition) <br />Number of devices Qf low vollage) <br />Description ol Wark to �e Done: <br />C�ry <br />City <br />State/Zip <br />StatelZip <br />State/Z�p <br />Phone <br />Phone <br />Phone <br />— Qo�VJ / � <br />City of Everett Busmess License Number (required) <br />� <br />Contrect Price of Work <br />�.��� [�jr;n��.�� Uzs-33�-s y� <br />on� tact Perso ontact Number/Email <br />�r <br />� <br />�dd,+���,u� �,�o A�n �yov �k-� ��- �-�-�_ ��, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />1 hemby cerfi/y lhaf 1 have read and examined fh+s applica(ion and kno�v flre same to 6e We and <br />correcL A/l pruvisions ollaws and ordinances goveming this type o! �vork wiU be completed <br />whefher speci(ed he�ein ornoL The gran6ng o/a pemiil does ncf presume fo give authonty to <br />violafe or cancel (he provisions ol any other sfafe orlocallaw m3ula(ing conslrucfion or fhe <br />perlomiance o/consWcfion. Thaf I am authonzed by Oie owner of Ihis property to perform Ih,e <br />woik lor which application is made and I comply with (he State Conlractors La�v 18.27 RCW and <br />�� � 1S' <br />REVISED 09iDGllO�J <br />F[E <br />� ��o <br />PERMITJt <br />E i50C�-(Xp�O <br />