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EI.ECTRICAL �ERMII° A�IPLOCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8£357 —ww�v.everettwa.org <br />�t/3 2 /i1 a1�0 •JCI /1-Ll� ;rcl-� <br />PROJECT ADDRESS <br />AL �-r1D2�� <br />Owner <br />Tenant <br />��� U 2 ' <br />ElecUica� Coniractor <br />%�i�2��PE9Gyl� P <br />Slate License Number (requued) <br />5:.� / � <br />Proposed se oF Building <br />Ictail Address <br />Atait Addie:s <br />razic <br />Mail Address <br />Square Foolage Qf residenlial new construction, remodel or addition) <br />Number of devices Qf low vollage) <br />Descriplion o( Work to Be Done: <br />City <br />Cily <br />i Sc✓ <br />Cily <br />% 6�2o✓n�� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />a —I'7 —IS, <br />� ��a���/�-. <br />State2�p <br />Slale/Z�p <br />Sta�eR�p <br />Phane <br />Phone <br />yzs=�yz-7a�6 <br />Phone <br />City f Everetl Business License Number (required) <br />�3oz�.bo <br />Contract Price of Work <br />Conlact Person/Contact NumbedEmail <br />�Xls% <br />%%9A //�,� <br />/<o D �` � Sv II �, <br />I hereby cerii(y fhat I h?ve read and examined this aFplicalion and knav the same to be tn�e and <br />correcL All provisions o/laws and o�dinanr.as goveming this fype ol work will be conrpleted <br />�vhefherspecified he�ein ornoL The granfing ol a pe�mit does nof presume fo give authoriry fo <br />violate or cancel fhe provisions o/any other sfa(e or local law �egidating consWction or tbe <br />pedonnance ol consWction. That I mn aufhonzed by fhe owner oI this property to peAonn !he <br />�vork lor �vhich applicatimi is made and I comply wifh Ihe Sfale Conf�acfo�s Lair 18 27 RCW and <br />296.200 VJAC. <br />��i'\�� �/��„-!� _2`�� �� <br />REVISEO 0&'Jf✓t0I J <br />FEE <br />�D � <br />PERMIT# �1 I I � <br />E I�D <br />� <br />