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� <br />►��.cf�. '��- <br />(�ev�s I rn� <br />ELECTRIGAL 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 />1 � ..� 5' h'Ir d'� �,�,�,�« ��� — <br />PROJECTADDRESS 9gzo � <br />aILP� ,�os7�- <br />OwnCr <br />Tenant <br />Elecirical <br />�dail Adtlress <br />Mad�tltlress <br />i l! c <br />Mail Adtlress <br />C.o���P( l9SYi,--+ <br />State License Number (required) <br />Proposed Use ot Ouilding <br />�CX�f�lF'�- il�Id/��- -� Z�J /�t�� <br />Square Foolage Q( resideNial n� conslruction, remodel or�ddion) <br />Number of devices (II low vollage) <br />Description o1 Work to Be Done: <br />CITY OF EVERETT LOCAL SALFS TAX CODE IS 3105 <br />City <br />Crty <br />Gly <br />�30 --- � �/ <br />i�r�.-�63 <br />%—� w� ��z� � 3� -�3y a, <br />Statel2�p Phone <br />SlatelLp Pnone <br />y25-293-z1 <br />��ioo�/ d'�rrx,>�v Y�'i?3 <br />State2ip Phone <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Conlact PersoNCon�acl NumbeUEmail <br />1 hereby ceRiJy fhat I have read and examined this applicafion and know the same to be We and <br />co�rect. AIf provisions olla�vs and ordinances goveming this type ol work �rill be cornplefed <br />whefher specdieJ he�em ornof. The grantrng ol a pemiif does not presume fo givc authonty fo <br />vio/afe or cancel fhe provisinns ol �ny ofherslale or local law reg�daGng conslruction or (he <br />peilnnnance ol consfruction Tnaf 1 am authonzed by Ihe o�vner o! th,is property to perfomi the <br />work for which application is nrade and I compty wifh fhe State Confractors Law 18.27 RCW and <br />296.200 WAC. <br />t�-�� - /y <br />Feviseo oarovao � a <br />FE[ <br />75 � <br />PERMITk <br />El�-O�-I�� <br />