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_ � <br /> ELF_CTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857 —www.everettwa.org <br /> �0—i�- /� <br /> I �1 �D Mc✓t,fi[.L C/2EEK f ti�ClCJ�9y ..5�'AG� A �� 7��"�� <br /> PROJECT ADDRESS <br /> ���.e�.��.,� ✓�20 �s�w�es c.�c �� �,� 908 K��.��w�,d _6L 1�R��3 <br /> Owner Mail Address City SIa�e2�p Phonc <br /> \/A G��1 �/i ' a_,� <br /> Tenant Ma�lAdtlress City Slate2ip Phone <br /> �w�L ELEct�� �40� MGIDDLL4NLL Av� F_vt,�a- l✓n� ���� yJf•75�-170u1 <br /> Electrieal Contraclor rda�l nddress Gry Slaie�bp Pnone <br /> �RNL�E1 �11LQ� � � � � ��1 <br /> State License Number(reqwred) Gty of Everetl Busmess License Number(required) <br /> �' l�, aso `u <br /> Proposed Use ol Ruilding Contract Pnce of Work <br /> I�wu S�)T14VEMS 3LU '��s� -�S11 <br /> OISIGVGNI@���L�CG�NIL•C6YV� <br /> Square Footage(II resideNial new construclion, remodel or adddion) Contact PersonlConlact Number/Email <br /> Number of devices(If low vollage) <br /> Uescnplion ol Work�o �e Done�. ��Q ��SCnNA1FGT,S �D�C ��LCG"t'1°�!'t,d <br /> ?R�.c�c �n�-�c�w6- 5rn�<�s <br /> _ F[E — — -- <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 _ . �I �� � 5 <br /> "f <br /> - -J-hereGy certdyfhaf 1 havr,read-and exarnmedYhis-apphcafion and-know fhc same lo"tie(rue and— --� ��-— �----��-�— -� � - - � <br /> cor�cr,f. All provis�ons ol/aws and ord�nances governrng tbis type of work wdl br complefed — <br /> �vf�efher spcabed hcrem or nof. The granfmg o/a permif dor.s not presumr. (o grve aufhanty fo PFRMITM —� <br /> vinlale or canr,M the provrsions ol any ofher sfnle orlocal law rr.gulahng r.onslroctron or fhr. E ��,� p -b(�(� <br /> pr.rinrntanr,e o/consfrur.fion. Thaf f am auflionzed by lhr, owner ol fNs property fo perlorm fhe <br /> �vo�k!or which applicaf�wi is made and I comply wdh!he Stafe Con(iactors Law 78.77 RCW anA <br /> 296200 W�C. <br /> - � / - - �b"�_�`�---- — <br /> Signalurc Dalc <br /> nFmseooavcom. <br />