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, <br /> ELECTKICAL PERMIT APF��ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org ��S�/ 5 <br /> C r5og-Ol�l <br /> � u c� " 3 ��� ,a v� S� - �ld.�j G � ?� �v►��3 <br /> PROJECT ADDRESS <br /> � H i4 P� �io�' ( �J�/�7 ��/[YLi�`� (,• 7c` `)k20) <br /> O�mc� 6fail�ddress Cily State2ip Phone <br /> D�.,�,�� G«.� �r�}. <br /> Tenant M11ail�dtlress Cily Slatc/Zlp Phonc <br /> U'��u.4P0L L;.LZti� �C.. �^ E'o`� `t`'�`� ki�tF �sCw7 �� `l�e`.�D�>> �`IlS) •�.i' ; ?o': <br /> Elect�ical Contractor hlail F+ddmss City Slate2ip y Phone <br /> �u���,�Ez 3oa �� oZ.o�iy <br /> Slate License Numbcr(required) City of Everett Business License Number(required) <br /> �f�A2T Y�,Lt,�s�`i y/' <br /> "roposed Usc of Duilding CoNracl Pricc of Work <br /> �/� '�'� T�Ca—�o�u1.i:✓l�A1WNrt�'�'.�L'%t� <br /> Square Footage Qf residential new construction,remodcl or addition) Conlact Person/Contact NumbedEmail <br /> N/A <br /> Number of devices Qf low vol!age) <br /> L7escnption of Wark �o E3e Uonc: �Sw�Yt L/E NE'17-L+`r G�vi N� CCY�c�C L i.� K•<-7vT a�= <br /> Lli>•,IZ? � F:v'{'t( F.c•.s5 � G�'ulr�G� 6}noE1$ ).J �p ldN Ils <br /> � "L c„ ��<vrrS i: S ;.-� cr�p �N ttc;c,.� :�r„�) <br /> F[E <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � r 0 � <br /> �� 0 <br /> I hereby ceAdy that I have read and examined Ihis applicalion and know the same fo Ge f�ue and <br /> conect. All provisions ollaws and ordinances goveming this lype ol�vodr ivill Ge comp/eled <br /> hcfher specilied herein ornoL The yrinfing of a pennif does nof presume fo give aul6wity fo PERMIT;t <br /> violafe or cancel the provisions ol any o(her s�ate or focal law regulahng construcfion or Ihe /, /, t <br /> peAonnance c!construction. ihat!am authonzed Ly fhe o�vner o/tl;rs property fo pc�io�m the E I 5'V�—V I� <br /> worlr lor�vhich applicalion is madr, and/comply with the S�atc Contractors Law iB.27 RCW and <br /> 29G.200 WAC. -- <br /> ----- '�u,��� �r- o��I �`l I( s <br /> signature ti - Uatc- <br /> RFVISEpOBNlJ101a �''1�1,1� �-��> �Nf.�. <br />