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ELECTRICAL PERMIT APF�LIc;ATION <br />CITY OF EVERETT PERMIT S�RVIC:ES <br />3200 CEDAR STREET. EVERETT, V'JA 98201 <br />425-257-8810 - FAX 425-257-8857 - v✓ww.everettwa.org <br />l� �a�-�y' <br />�.7 J���iCc� �IJ� �uz2�', iJ/�-4gZu� ���i��—l�� <br />PROJECT ADDRESS <br />��-z <br />c��GrCS IOGS /�iJIL�If�J IJ� �LU?/C�I% ��!'� �g�0/ �`J�{- <br />Owner ldailAddress C�ty Sta!�eilip Phone <br />Tenan� Mail Atldress ��ry <br />li� • {1oUs,P ilee�rrL 3 �6 IJ�o�du•., �� <br />ElectricalConlraclor Ma�tAddress Gty <br />,TN t1t� I.�S�9r�2C��r <br />� �r„-�� <br />� L � "� > <br />Sla�� License Number (requirea) <br />1 �c�Sj �`G�,�; Y a-� <br />Proposed Use of Bulld ng <br />Z0��8 � <br />Square Footaye Q( r sidential ne� construction, remodel or addihon) <br />Number of devices ��f low vollage) <br />�� <br />State�'Lp <br />t� $C b. <br />StatelZ p <br />Phone <br />Phone <br />�1q� O`�`!/G'� <br />City of 6verett Elus esYC� eC nse Number (reqwred) <br />� Gd <br />Conlract Price of Work <br />��i-rrC1C �lc��c/ Z,s- %`-Z 3-�5 i�� <br />Ccntacl Person/Conta Nur�,bedEmail <br />�escription of Work to 8� Done: �U`� LO��e�N�^� _—_--_- <br />CITY OF EVERETT LOCAL SALES ThX CODE IS 3705 <br />1 hereby cerfilylh2f 1 have read and exarroned fhis applicafron and kncw Ihe same to be We and <br />correct. All provisio.vs olla�vs and orrlinances goveming this type ol�vork �vtll be completed <br />�vhefher speci�ed he�pin or noL The granfing o/ a pemtif does nol pmsume to give aufhonty lo <br />violafe or cancel lhe provisions ol any othersta;e orlocal law mgula(ing construcGon or the <br />peAormance o/ consWcfion. That I am authonzad by the on�ner o/ this property fo peAonn fhe <br />work for which applicafion is made and 1 comply wi.'h fhe Stafe Confractors Law 18.27 RCW and <br />�oe �an wnc <br />REVISEDOBNfirlOia <br />FEE <br />��o� <br />PERMIT# <br />E���o-�71 <br />