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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www everettwa.org <br />r f S05--/6 G <br />2 T We -Sr Ica;Ll &A: <br />PROJECT ADDRESS <br />- 2 �T 1 y-i u AW Eve C <br />Owner triad Address Cdy State/Zip <br />aNe- <br />Tenant <br />triad Address <br />C+ly <br />State/Zip Phone <br />?ftJ►" <br />Z.-c;> <br />tab, t,4 283"t-1 5�3s <br />Electrical Contractor <br />triad Address <br />Cly <br />Slatelzp Phone <br />Le W E E+ 936 P9 <br />Stale License Number (required) <br />e,S' AC'-)j•)ac, <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />—Cx ash-Ssc�rq�L _— <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />253. 6701350G <br />Contact PersonlConlact Number/Email <br />I hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work wit.' be completed <br />whether specified herein or not. The granting of a permit does not presume to give authonly to <br />violate or cancel the provisions of any other state orlocal law regulating const uchon or the <br />perfomiance or construction. That I am authorized by the owner of this property to perform the <br />work for tvhr plication is made and I con:;,,y :rith the State Contractors Law 18.27 RCW and <br />296. AC. � -) /l_n <br />PEWSEDOMi 014 <br />,#_;_�il Ax^ TO <br />--- <br />� 'jcj.00 <br />PFRMITft <br />E 1505- l (01 <br />