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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3300 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wvvw.e� erettv+a.org �� `- `� / 3 <br />�3 �r� �� C� �i ��/�-C�' <br />PROJECTADDRESS <br />O�vner <br />y <br />Etectrical Con�ractor tdail Addrss <br />��� ��,�� �r��� -3 <br />State License Number <br />- ;�- D <br />Proposed Use of Building <br />Square Footage Qf residential new conslruction, remodel or addition) <br />Ninnber of devices (If low voltage) <br />City <br />C,C/3! �� ��ti�� <br />;03 <br />S�ate/Zip <br />�o <br />Phore <br />rE'J�orc <br />; , �� zs ���, <br />Stale/Z�p Phone <br />� �.�� -- <br />Contract Price of Work <br />Contact Person (Plan Revievi) <br />Descriplion of Woik to Bc Donc �£ �tC Q T ��% �� / / ` �� ` � � ���— � � . �U —/.— <br />CI1Y OF EVERETT LOCAL SALES TAX CODE IS 9705 <br />! hereby certily Uiaf I have read and examined (his application and know fhe same fo be tn�e and <br />cormcf. �111 pruvisions ollaws and ordinances goveming (Iris type oI woik will be cornpleted <br />whefher specified herein or noL The gianting o/ a pem�if does not presume fo give aulhonty fo <br />violafe orcancel fhe provisions olany othersfate orlocalla�v regulafing cons6uction or the <br />pedonnance o/ consfruclior,. That I drn authonzed by l�re o�vner of lhis property (o perfomi fhe <br />�vo�k fo� �vhich applica(ion is made and I compty wifh fhe Stafe Contiac(ors Law 18.27 RCW and <br />�oa onn uinr <br />HCV6ED 17W17 <br />FEE <br />5b�oo <br />P[R�11T� <br />E �310-088 <br />