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425-152-16fifi CMHEATING 01:38�OSpm. 10-29-:014 )�3 <br /> EL�CTRICAL PERMIT APPLICATION <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> �I yi�-l�'� <br /> )►-I-I(v IYIA�Le St -��/ �Sz�l ����9''y <br /> PROJECT ADDRESS <br /> �����a.vr�S sQ,�l;�,e�ct,�� �� 339 /u� <br /> Owner Mail Addross Clty St�le2lp Phone <br /> Tenant �dallAddress Cily SWtelZlp Phone <br /> �Ill LaPn-y�NG ( YlG ��}�J r]"6C�1.Z7Ci1,1 Evet��t W A- q��� 4-Z�j �� �r�v�r� <br /> Electrical Conlra ar Mall Addross City Stale2ip P�one <br /> Crn��M�+R�� � o� �oq � <br /> State Llcense Numher(required) City of Everett Business License Number(required) <br /> Z50 '" <br /> Proposed Use of Bullding Coniract Price of Work <br /> 1�2.� �Z5 Z5q (da6F.� <br />� SGuare Footage Q(residenlial new conslructlon, remodel vr addiUon) aonlacl Person/Conlacl NumbedEmail <br /> Number of devices(If low voliage) <br /> Descriplion of Work lo Bc Done: � �{� � � .(,�C1,(/� <br /> FEL• <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /^O O� <br /> I hereby ce�tily tha(1 hava rood and examined fhls application and know the samu fa be(rvo ond r�, <br /> cortect. All pmvlsions ollaws and ordinuncos goveming this(ypn of warlc will be completed � <br /> whether spocified horeln or noL The granfing oI a permit does nnt prvsumo to givo authanty(o I pERMITit ��. t <br /> violale or cincel fhe provlslons oI nny ofher s(ato or local law my�lafing consfrucfion orfhe ^ 1 � �-� <br /> poAormance o/consfruclfon. That I am aulhonzod by(lio ownerollhis property fo perform fhe t � � <br /> work forwhicl�applicafion is madc and 1 comply wilh(he Stalo Contracfors La�v 18.27 RCW nnd <br /> 296.200 WAC. <br /> . <br /> 9• <br /> ignalure Dalo <br /> NEVISEDddCft^m! I <br /> --_J <br />