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ELECTRICAL 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 />p�o— / /'(G�U�G � <br />PROJECT ADDRESS <br />Ovmer <br />TenaN <br />r � <br />�� �,�n�n� / . D.2�j 223 <br />�a�l AJdress <br />Mau aadress <br />IC�j�I_�_� �.D.�u �17� <br />[lectrical Coniractor <br />Addiess <br />1(L�F�E DC �38N 7 <br />Stale License Number <br />�,���� �� <br />Proposed Use of Building <br />/�"�D? <br />S uare Footage (It res�d�nlial new conslruc�ion, remodel or adddion) <br />Number o( devices (If bw vollage) <br />Description o� Work lo Be Done: <br />C,ly <br />City <br />Gty <br />Slale�Zip <br />State/Zip <br />State/Zip <br />y _Iz—�3 <br />Ei3�y��'1/ <br />. �G�UU, <br />Contract Price of Work <br />�C�fJ� �U�'jt7r�i <br />0 <br />Contact Person (Plan Revie�v) <br />-tjb��-91.. ,e � �.IR_��_s� -ir.M `l��c�,+t�— . <br />1Niri��9 + ci�cuih" on(� <br />� 20 � FEF <br />CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 C� <br />I hereby ce�iily fhat I have read and exarnined this application and know (he same fo he tr.�e and <br />coirect. All p�ovisions o/ laws and ordinances goveming N�is 'vpe of work �vill be comple(ed <br />�vhelher speci�ed herein ornot The granfing o/ a pemiit doea � iof presume (o give authorily fo <br />violate orcancel fhe provlsions ol any othersfate or local la�v mgulafing cons(niction or the <br />pedmmm�ce o/ consln�ction. Thaf I am authonzed by the o�vner of this property (o pedorm the <br />work /or �vhich application is made and 1 comply enfh Ihe Sfafe Confraclors La�v 78.27 RCW and <br />296 200 Wr�C. _ � <br />Fe�,�m �n,•, <br />7J <br />P[RMIT� <br />El3o�--bq� <br />Phone <br />Phone <br />�s a� <br />F'hone <br />