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ELECTRICAL PERMIT APPLICA�i ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 – �wvw.everettwa org <br />1511 McDou(,A�� AvE EvE2� wA ���ol <br />PROJECT ADDRESS <br />Q�.� QT NU�,HL S `�g �U 12S PL S�, �.�El'Fi"T- �,�lA 491A(� 42S S� �'+3� <br />Owner �da�i n�dress Cuy Siatcr7io anorc <br />Tenant <br />� WY1 �� <br />Eiertr.cal Contrac;or <br />L�cense N�Mber Ireqwretl) <br />`ddd Adaress <br />,'Aa�' rtltlie55 <br />Si�c,�LE FA�n���l HoM4 <br />ProGosed Use ol C3udd�ng <br />1u?p <br />, Square Foo'age ilf res�.dential rew construct o� �remodel or atld�'ionl <br />Numher of dewces III ��ow voltagcl <br />C�ry <br />C.ty <br />StalelZ�p <br />State�Z�p <br />Phone <br />rhone <br />Cdy ol Everett Business lmense Numher (required) <br />Conlracl Pnce ol Work <br />�cA`�e-�–NuG�£�_ �I2S 530 <br />Con;act Person.Contact NumheriEmad <br />��ctlo��cw�ctiy Q r�sn. <br />c c r.. <br />Ucscnptmn ol �York to Bc Done ,NSTAL�- PoW 4t�F.D I�N �c RCUN-UEr TE D SMQK� �E7EC Ti��S,_ <br />I�STAI.I_ ti1Cw k�bC�\EN P�uhSiMcvE Sn�UE`i A1-� L�NE 1APiT��T �� �-I-�� <br />LN A (LO�-- — <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hc/ehy cerLty (haf I Y,ave road anJ e�an�ined Ih�s dpp�.cnlion and know Ihe 5amr. to be trur, ar,d <br />co�recf i111 pruvisions ollaw�s an,7 ordin,rnces qovrrnrng th�s type o! woik wrll ho comple��ed <br />�vhether spec�fied hwem oi nol ihe y�anGng ol a pennd does nol presume fo 9rve aufhonty to <br />viola�e or cance� fho provrsions o/any ofher state o� local Inn� regWaLnq mnstmclron or fhe <br />pertomrance o/conslructron That 1 am ,�Whnn:ed by fho o�cner ol fhis pmpeRy fo peAomr Ihe <br />aorN lo� wbich app6cahon �s rnade inA 1 comply r:dh Ihc• Sfale Contractors Lnw f 8 27 RCW and <br />296 200 W�1 C <br />FE[ <br />80 °� <br />[PeRr�rrx � <br />�Ni50S- oo� <br />�w��, .._.c•:.,-,:�� <br />