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ELECTRICAL PERMIT APPLICATION <br />CITY OF EYEE2ETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />/��1<3/ ,G�o�Ji?0 � �i�° /�ii.Pi�v�/, <br />PROJECT ADDRESS <br />!�� ��`�3 <br />�13/!-a�S <br />�/%!/iY�4�l0��1 /�/?O�S �O���GG�C SIa1MZip Phone <br />Owner Mail Address Y <br />Tenant <br />� <br />Electrical Contraclor <br />%/JFi/I'Es 9�/� ..r� <br />Slate License Number <br />Proposed Use ol Building <br />Mail Address <br />Mail Add�ess <br />Square Foolage Qf residential new construction, remodel or addition) <br />Number o( devices (I( low vollage) <br />Description of Work to Re Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS a105 <br />City <br />City <br />)� <br />StalclZlp <br />Statc2ip <br />Contracl P�e of Work <br />CoMact Person (Plan Review) <br />I hereby ccifilylhaf f have read and examined this applicafion and know fhe same (o be tn�e and <br />r.onecl. All prnvisions ollaws and o�dinances goveming fhis type ol work wdl be complefed <br />wh^Iherspecified herein ornof. ihe granting a/a pennit does nof presurnc fo qivc cmfhonty lo <br />violafe orcnneel the provisions ol any o(her sfafe or local law re yidaling conslnic6on nr fhe <br />peAonnance oI consfn�c(iorr. Thaf I arn aidhonzed by fhe owncr o/ fhis property lo peAortn (he <br />v�o�k lor which applica(ion is made and 1 comply wrth the Slate Conhaclors L�w 78.27 RCW and <br />296.200 W�C <br />� ,l.7 Ll�l%(/c v lil0l� �� O/ ���. — — <br />S�gnaWrc ' Dale <br />Rr.v�sr:o vlmu <br />Phone <br />- r�� � <br />Phonc <br />FF[ <br />75�0 <br />PERMITl1 <br />E13(f �vu� <br />