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ELEC�'RICAL PERMIT APPL'�ATION <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 />���� � ;�, , �iTF� <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />A!'r S Gv <br />Meil Address <br />Mail Address <br />Cily <br />City <br />�-a b��� <br />�1303� ►7�i <br />L /4" <br />State/Zip <br />SlalelZip <br />Phone <br />Phone <br />�, r�i �l� Ti 9G.Z4�$ .U%h 5� y� a�.4 9�.LSb' -- <br />`,� S��� ` I L Cit State/Zip Phone <br />[lectrical Conlraclor Mail Address /- Y ���its� :�//� ri 5-/ <br />G!i!�-C �I �f.�lr� 5 <br />, „57�t1 � ?� n K <br />Slate License Number <br />�� <br />1i'�;. ,��,,� ,'n� <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addilion) <br />Number of devices (If low vollage) <br />��� 1�� <br />Conlract rice of Work <br />L/[i t `m , / v, - <br />Contact Person (Plan Review) <br />IDescriplion of VVork to Be Done: �� Ni � t'l/� �� '`� � �� � 'L �r J P/� r i1 S r�� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerfify that I Irave read and exami.neAthis application and knor✓ lhe same to be tn�e and <br />cormcL All provisions ollaws and ordinances goveming tbis fype of tvork will be comp/eted <br />�:�hefher specified he�vin or noL The granting ol a pennif does not pr�esume to give aulhonty fo <br />,.-iolate or cancel the provisions oI any otherstate orlocal/aw mgulafing consfruction orfhe <br />pafomianco oI constructron. That 1 am aulhoiized by fhe owner ol this properiy lo perfonn ths <br />�„ork lor wNich applicafiai is made and ! comply wifh the Stafe Cont�actors Lmv 18.27 RCW and <br />?P6.200 WAC. <br />,�L;�' �,l � �3/.� � /v-� � 2� <br />1Z ate <br />FEE <br />y� -� � OC� <br />PERMIT�t <br />E �,_ .� <br />;��_: �- � �� <br />