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. � ELECTR�CA� PERIIAIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> •725-257-8810 - FAX 425-257-8857 —www.everettwa org <br /> 7203 L� �ym� �� �r�vc <br /> PROJECT ADDRESS ��,. <br /> To�-.-, PN I-� � Zo'� D��ntit�ic 1J�' EUe�.`t}' �vA- a8z� "794_ �3 <br /> OwOB� —r Mad Atld�ess Gty Slate�ZiO Phone <br /> Tenanl tJa•.i Atldress Cdy Stale2�p Phone <br /> ��--ir�}.� E�c.-�ric ��-C IS4�t7 -���Avc.S�. Srwwm�sl� �/p `fK2�6 (bg-5 <br /> Electrical Conlractor Mail Address CAy Slale/Zp Pnone <br /> T�2i►.f� �Lq 24 �7 �,�, • �zli� l'Lt��s b 2 S <br /> �ta,e License Number(required) Ciry o`Everett Bus�ness �cense Number(requlred) <br /> SF,� �I5�0° -- — <br /> Proposed Use of E3wlding Contracl Pnce of Work <br /> r�A - J��� wh�,�� 3a6 ��bs-s�; <br /> Square Footage QI residenlial new construction, remodel or adddion) Conlact PersoniContact Number/Email <br /> ,, je��C-lr��:t.�e►«�<«� . ►�.�- <br /> Number of devices(If low voltaga) • � . _ I <br /> �v/U�V`U ele(�1�,�� -�°►�' � d�l <br /> Descriplion of Work lo Be Done M1--� ��' . K —�u�� aL� re�� <br /> r-ee <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 �"'I c.Q�� <br /> �J <br /> I hereby cerlity thaf 1 have read and exammed this apphca6on and knon�the same fo be tiue anA <br /> conecf All provisions o/la�vs and ordinances goveming this lype oI work wdl be complelr,d <br /> whrfherspecdieQ ho�ein or not. The gran6ng ol a permd does not presume to givc aulhonty lo PERMITSf <br /> v�olafe ur cancel 1ho provlsions of any otber sfafe or local law regulabng consfrucfron or the � 1� ��� 1�1 I <br /> peAormance ol conslnicfion. Thaf I am authonzed by tha owner of tbis praperfy fe pe�form the �•'t <br /> work lor which appbca6on is made and 1 comply wRh fhe State Controclors La�v 18 27 RCW and <br /> 296.200 WAC. <br /> t,�.,t�. 3Iz7��S -- <br /> Si ia re Date <br /> NFa;Sfil a491 Y 1� <br />