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•— --- - -- — -- ---�-- - --- <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 982U1 <br />425-257-8810 - FAX 425-257-8857 - www evereltwa.org <br />� '?��� 12c,�K�r 1�VC CI��Y�.� <br />� <br />� PROJECT ADDRESS <br />� '� W ��e�<.�• �1 .�� � , • , ..., l�v�= C1�Pi e� I I �u', / �11' �- i -- <br />Owner f�AadAodress Gty Statc2�p Phone <br />Tenant <br />Eleclncal <br />MadAtldress <br />tda�t ACdress <br />FIAwI< �E��� Icl <br />Statc License Number (requved) <br />� f��1i!/ (' I'6!i uCl1� � <br />i P�oposed Use of Buddiny <br />I <br />' ��CNc <br />Square footage (If res�dent�al new conslruct�on, remodel or addd�on) <br />� p���7v <br />� Number o( devices Qf low voltage) <br />Gty <br />Statc/Z�o <br />p <br />Phonc <br />��� <br />Phone <br />052z�7 <br />City of [verelt Business License Number (required) <br />%' / �_ Uw � — <br />Contract Price o( Work <br />r,���l��l���l�s/�as;3�a��1 - <br />Cont�'ct PersonlConlacl NumbedEmad <br />Descriplion of Work to Be Done � S�� •/1 � �E h�'�+c'�1�� --_ <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereb}� certdy lhat I have read and examined thrs apphco0on and kno�:- Ihe sarne lo Ge bue and <br />conecf. All provismns o//aws and o�dinances governmg this type ol �vork �vill be completed <br />�vhefherspecrfir,d he�em ornoL The g�an(ing o/a pennit Uoes nof presume to g�ve authonty �o <br />violate or cancel the provisions o/ any ulher s(ate or local la�v regulating constn�ction or fhe <br />perfortnance o(consWclion. Thaf I am authonzed by fhe o�vner ol fhis property fo peAomi the <br />u-urk lor �t�hich application is made and I comply n�ith the State Contracto�s Law 18.27 RCW and <br />296.200WACi „ <br />. . __-or=r..;,.r: <br />�___ —_'___—___ _.. <br />FEE -� <br />�l D �� i <br />_ _— _.._J <br />PERt•tIT» � <br />E iyl0 —l'�9 , <br />