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ELECT!'.ICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br /><25-257-8610 - FAX 425-257-8857 — www.everettwa.org <br />2. 3 2 O �c �a c��G �� �lv �e <br />PROJECT A�DRESS Z 3 2p p1 L OUc�c�� I� <br />� <br />S �„.. �� S¢o �-�" � v e r P t� (.v/4 <br />OH'�1C'r ldad AtlOre55 C��Y <br />I ienant tda�l Atltlress Cny <br />,5�1 �! G �e/+ <br />2 / � � <br />i✓r�oG,�F�c� � fGd"I'I G T�l C_ ���r Btl� <br />Elect � I CoNracior Ma�i ada�ess ���v <br />�'GN �.� 977 �� <br />S�ate License Number <br />S�D <br />Prcposetl Use of Bu�itlmg <br />� __-L�Q� <br />Square Footage p( res�dential new tonstrucUon remodel or adAnionl <br />Number of dewces (If lo��, voltage� <br />DescnpUon of Work to Be Done <br />1/-/Z-/3 <br />.. o�/ <br />A�g Zo� yz5-z�o- S�y L <br />StatelLp Pnone i <br />,P� �� ��yc•�Z�i� �yZS/ Phone <br />i,�l4. 9i�7 3 �1zZ-z95d <br />Slate2io Pnone <br />Cortracl Pnce of Work <br />ContactPerson iPlanRewew� <br />��c��a0��� ' �s <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />1 hereby certdy thaf I have read and exarnmed Ihis applicalion and kno:v fhe same to he hue and <br />concct. qll pmwsions o/ laws and nrtLnances goveming fhis fype ol work �:-in Ae cornpleted <br />v:hefhcr specified herein or not. 7lre granhng o! a pennif does nol presume lo grve authonty fo <br />viola(e or cancel the provisions o�any other sfate or local la�v mgufafing construcfrai or ihe <br />peAomianrn olconshuc6on. Tbaf 1 am a�dhonzed by the ow,ner ol fh�s propetly fo peAorm the <br />woik !or n�hrch applicaUon is made and I r.omply wdh fhe Sfafe Confracfors Law 78.27 RCW and <br />FEE <br />�O� <br />PERMITk <br />E I 31 - 0(� <br />