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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 f/Z,�� _� � <br />425-257-8810 - FAX 425-257-8857 — www everetiv+a.org <br />EI �ilz --�il <br />5�( l�-dcf�:�el�e� A�� ��eref � I,��, ��203 <br />PROJECT ADDRESS <br />c.���S �oT��in <br />IOwner <br />Tenant <br />� GI ��a � <br />I Gleclrical Co racic <br />53�1 <br />h9ail Address <br />Mail Address <br />��� 6��-g � <br />IAad Address <br />AL�c IE f2�� �A <br />State license Number (required) <br />Proposed Use of �uild�ng <br />a01(� <br />Square Footage Qf residenlial new construdion, remodel or adddion) <br />Number o( devices Qf low voltage) <br />City <br />Gry <br />C�ty <br />StatelZ�p <br />State/Zip <br />�,.�sl 3S3 <br />167� <br />�� � <br />P�one <br />Phone <br />I,�a ��171 (zac�sii-6333 � <br />State2�p Phone �; <br />a5oda2 �', <br />Cdy of [vcrell nusiness License Number (required) I <br />�136c�- � � � <br />CoMracl Price of Work ', <br />II <br />Contact PersoNConlact NumbedEmad � <br />I, Description of Work lo Be Done (Y4`"evE Mln�+� SL.I �' �% ,�n�j�a � 2�4 G''^�6�� ��Fl�� Li_t_ <br />1 ,�c�,.) SO c,Mn. G'10 <br />�. <br />ree D� <br />CITY OF EVERET7 LOCAL SALES TAX CODE- IS �105 v, D <br />I hemby cerl�(y thaf I have �cad and examined this applicafion and know the same fo be (n�e nnd � <br />correcf. All p�ovisions o/laws and ordinances governing fhis type o/ �va1c u-ill Ge completed <br />�:hethcr speci�ed herem oi noL The g�anting oI a pemut does nof pmsume fo give authonty (o P[RMIT# <br />violafr. or cancel fhe provisions ol any other slafe or local faw rog�daling construction or fhe r I � 1 I�— O� I <br />perfonnance o/conslvction. That I am aufhomed by the owne� o/ (his pn�perty to peAorm Ihe t'"j <br />worfi lo� whic' �pplication is made anA I compty �ti�ith the S(afe Contrac(ors Law 18.27 RCW and <br />296 200};S�AC. � <br />IZ� ��-26« <br />i:F. �'I SED OdOGYO i J <br />