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— �— — ----� -- — - <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT �ERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www everett��a org <br />2�32 iN�� w{. � ' �/+v.-� <br />PROJECTADDRESS <br />�ln 1U1 Z-ooz <br />� a �-5-�� <br />j i%e✓'c��n � �� ����c_S _ i <br />• Owner �dad ACtlress C�ly Stale2 p Phone ' <br />Tenant <br />tdaii�ddress <br />C�ry <br />State/Lp <br />Phone <br />���� <br />l�lMC,O �'C:1LC=N'� �-%L_ 7z� I-1�,�c,�.��n w'� . C'e.�in�u/:0 �sl. q�Gg?_ _72Z �9l D <br />ElecinCal Coniractor �daB Adtlmss Cny Slate2p Phone <br />� , �� /� l�t/l4� � c,��6a1�1� <br />Slate License Number (required) <br />Proposed Use o( Budding <br />17U(� <br />Square Fuotage Qf res�dential new construction, remoUel or adddwn) <br />Number of devices QI brr vollage) <br />o� SQ�t� _ <br />Gry of Everett Bus�ness Gcense Nun•.oer (iequired) <br />_�a <br />Contrac Price of Work <br />Contad Pr.rson/Contact Numbed[mail <br />Descnption ol Work lo He Donc: _ �"t�V v� L--�' _ <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS J105 <br />I hereby certily (hal I have rcad and exanuned Ihis applicalion �nd 4no�v Ihe same to be (nle and <br />correcf All provisions ol la�vs and ordinances govemmg (his type ol woric wrll be cumplcled <br />whefher speci(ed hemm a not The granfmg of a pemiit does not presume fo grve authonty to <br />violafe or cancel fhe proviswns ol any ofher state or local /aw re9ulahng consfiucfion or the <br />peAonnance ol construcfion. That I am au(honzed by the o�v ro/ fhis property fo perform !he <br />work lor ivh�ch applicahon �s madc and I comply �vifh the St�Confractors Law 78.27 RCW and <br />296.200 WAC. /� _ � <br />IL <br />FEVlSEDOBN6?01: <br />1=EE <br />8��' <br />PERMII N <br />EiN1�iz- DUZ <br />