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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERET'i PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 • <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />23/Y Mo�vrzo� /��� <br />PROJECT ADDRESS <br />�(�ly-l�f ,/ <br />�I�oN�ogy <br />�r�R�2T L�RAv�S yaS 35s-57st� <br />Ownef Mail Address City Slale/Zip Pnone <br />Tenant <br />Electrical <br />Mail Address <br />Mail Address <br />�c-r i��E�ao3N.i <br />State License Number <br />SF/Z <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number o( devices (If low voltage) <br />Cily <br />Ci�y <br />Slale/Zip Phone <br />/H/KF_ CECL <br />y�.S 30`3- O(q4� <br />S�ate/Zip Phone <br />Contrad Price of Work <br />Conlact Person (Plan Revie�v) <br />Description of Work lo Be Done: /eE f'(J�t C� CXS/S f/�VC� Z 00 /� Z/NSCO 4o A� CiJVr�•(2_ <br />�LL��l �vEw oo nntt� M!#iN ,eQ,=a��I'l t-c��0 c��.,ur�l2 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hemby certily thal I have read and examined this applicalion and know the same to be (nie and <br />correcl. All provisions o( laws and ordinances goveming this type o/ work will be conipleted <br />whefher speci�ed berein or noL The granting o/ a pertnil does nof presume fo give authonty fo <br />violate or cancel the provisions ol any otherslate orlocal law reyulafing consfroction or fBe <br />peAormance ol consWction. That 1 am authonzed by Ihe owner o/ this property fo pedonn fhe <br />work lor which application is rnade and 1 comply with !he Sfate Confracfors Law 18.27 RCW and <br />296.200 WAC. <br />REVISEU7Rdq <br />FEE <br />� ��� <br />PERM [T# <br />E I � ��! -b� �{ <br />