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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257•8810 - FAX 425-257-8857 — www.everettwa.org <br />,58 32� c�A K�.� �� � . <br />PROJECT ADDRESS <br />12 -�-'�—�`'� <br />L /�j / � —l�i"/ <br />9� � 4-c�4 6 8 <br />�-�r��P� �O81i�rc� � ���,Sfih.�a� �S� _ <br />Owner h1ai�AtlGress City State2p Phone <br />Temnt <br />M1tad Address <br />C�ry <br />Statc2�P <br />Phone <br />����s�� ���ki��l e.�. Po3�����co �e��+ _���e� yas��3�^a3� ( <br />Eleciric8l CoN�aClor A9a�.l Addrass Ciry Slate2p P�one <br />�; r� ss �c 9� � P (>- _ <br />Stale License Number <br />9�PSIc�P t�1C.P <br />Proposed Use af B�ilding <br />Squa�e Footage (It residential new conslrucfion, remodel or addition) <br />Number ol devices Q� low voltaye) <br />Contracl Price of Nbrk <br />Conlact Person (Plan Review) <br />Description ol Woik to Be Dona �1�_��[t1��L1Q.Q�C�W� 2 -- <br />CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certd}� fhaf I have read mid examined fhis applicafion and know the same to be frue anU <br />correct. All p�ovisions ollaws and ordinances goveming Ihrs type ol work wdl be compleled <br />whether specilied hemm or noL The granfing o/ a pemiif does nof pmsume to give airthonty lo <br />violate or cancel fhe provisions ol any ofher slate orlocal law mgulafing consfn�clion or fhe <br />perionnance ol consfruclion. That I am aufhonzed by fhe o�vner ol (hls property fo pedonn the <br />�cork lor �vhich appGcafion is maAe and 1 comply wilh Ihe Stafe Contractors Law 182; RCW ��nd <br />296 200 WAC. „ <br />ppVbEO 1:a'I ) <br />FE[ � <br />�5 00 <br />P[RMIT» <br />E131Z-((�� <br />