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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8357 — www.everettwa.org <br />�005 vJesk �M�k{�eo �1�� <br />PROJECT ADDRESS <br />� N <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />E� �a5 -� 53 <br />S _a�-,S <br />W� c <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />�qY1n2Y �(cc+Vl� � i�0 ��� P�a�nl wA R�LSZ 36071y �8bf <br />Electrical Contrador tdail Adtlress Ciry Sta!e/Z�p Phone <br />�anne��9/�SRP <br />Slate License Number (required) <br />Solar I+�s1���whw� <br />Proposed Use of Building <br />Square Footage (If residential new consiruction, remodel or addi�ion) <br />Number of devices (If low volt �e) <br />City of Everetl Business License Number (required) <br />Contrad Price of Work <br />Contacl PersonlContact NumbedEmail <br />Descripi�on of Work ta Be Done: `hS�`1 ��Or ���" d'� �1«s"�1/�S '�eS�c�^ w <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />1 hereby ceiiily fhaf I have read and examined this app/icafion and know the same fo be frue and <br />coire,:t. AIf provisia�s o/laivs and ordinances goveming this type ol work will be completed <br />whefher specified herein or noL The granting of a pemiit does nof pmsume to give authonty lo <br />violafe or cancel the provisions ol any othersfafe or local law r2gulafing consf�uction or the <br />pe�formance ol consWcfion. That 1 am aufhonzed by the ownerol this property to perform the <br />worlc lor wh h applicafio is made and I comply with lhe State Contraclors La�v 18.27 RCW and <br />296.200�C. , /j � <br />S <br />FevisEa earow.oia <br />FEE <br />� D°o <br />PERMIT# <br />E «D�— r�3 <br />