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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEOAR STR�ET, EVER6TT, V�JA 98201 <br />425-257-8810 - PAX 425-257-8857 -'�vtiv.everettwa.org <br />� Z i �v i � CS ,9 v C <br />PROJECTADDRESS <br />Owner <br />Tenanl <br />� SlitEller � 2l NI ��s <br />Na�l Address <br />Ata�l Atldress <br />�F � v��crr <br />Crty <br />C ity <br />3 ���-iu <br />o� <br />� �lfG_��-� � <br />l/��9 y�2o/ `/1S-1b�- <br />SlatclZip Phonc <br />Slate2�p Phene <br />'I,, tGEGIn e rr�� 11/l0 2 2 ro s; .1 � lr9l1tt7�ver.�+J G•� 9�1fP yzt- 31Y 9'J9L <br />�dNs�r � <br />Cdy SWIeZp Pho�c <br />ElecliicalContracbr 1.taJAddiess <br />f3N{ B'f �lz �a <br />State Licensa Nwnbcr <br />Jf2 <br />Proposed Use of �uilding <br />Square Footage Qf residential new conslruction, remodel or addition) <br />Numher of devices QI low vallage) <br />2 ��� <br />Contra 1 Pr�ce of 4Verk <br />Contact Pe+son (Plan Revien) <br />SNS1'qLL e �oo�l�y� ,stnU�cc <br />Description o( Woik to Bc Done: _Lv—l[✓-- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />I hereGy cert�ly that 1 have read and eramined Ihis applicafion and Ano�v the same l0 6e frue and <br />correcf. i111 provisions of la�vs and ordinances g�vemin9 (his lype of �vork �rill be compleled <br />�:�helher speci�ed he�ein ornoL The granting ol a pem�if does nof presmne fo give authonry (o <br />violate orcancel lhe provisions ol any ofher stafe nrlocalla�v regulaling consfrucfion or Ihe <br />pe�fo�mance olconstrucfion. Thaf f am aufhonzed by (he owner ol fhis property to peAormlhe <br />�vo�k !or whiclr applicafion is made and 1 cempty wifh fhe Slale Confraclors Law 1827 RCLV and <br />296 200 WAC. � <br />%��-- 3 z o <br />FEE <br />75°-- <br />�Fr�r�rrn <br />EIy03-Oq8 <br />