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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 />C�lgoa--01) <br />I lose ()Lx� <br />PROJECT ADDRESS <br />�oSh Sm l� loy3o Qoxw�� Pale , 91 <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip <br />Phone <br />\N es,-crn Solc,,- 319 C Cho-v-y\Q' 6h SA , 1'�e 9 $3,-Ly- <br />Electrical Contractor Mail Address City StatefZip Phone <br />\NL*4�iaDO <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new construction. remodel or addition) <br />Number of devices (If low voltage) <br />S $tlsOU ,op <br />Contract Price of Work <br />f�r;c_ C3tG-1-2 <br />Contact Person (Plan Review) <br />3(00- 9-ro-i - Q�s3`l <br />Description of Work to Be Done <,; ��klJ 90t,ey- QYho,:�Qf ('Oa-(- MUy(\kCA <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this applicab!)n and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whether spociricd herein or not. The granting ola permit does not presume to givo authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />perfomtance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAG <br />1 1? W I <br />PEVISEDIWI. <br />FEE <br />/O� <br />PERMIT/8 <br />EILi-az- 61-7 <br />