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ELECTRICAL �ERMIT AP�LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />� 3200 CEDAR STREET, EVERETT, WA 98201 <br />! 425-257-8810 - FAX 42�257-8857 - w�w everemva.gov <br />I ��� U,�-In,�� /�.�� �J� ��r 20 � <br />�J:�nx�r_�.v:�� <br />[Is/� -l�I <br />�Q`-��"I.S <br />l� J(.¢) <br />q3z o� <br />S�o'l ��a�LS'o� � 74� V�(c�;.t� f�V2 EUUC� L,� �'�00�_ <br />Ovmer Mail Address C'y StalelZ.p Phone <br />ITenant <br />Mail AGd�ess <br />� ��.u�',� i�� ����,',� Sti<< lto�" s.— �' F <br />Etectr.cal Contraclor 1lau Fed�ess <br />i �q �;-rl�� q35 0 �f <br />, S� License Number �reqwred) <br />I S��l.� -{� �.�: ��t'1 c s;�1 �,� �-� <br />I Propr.se se of Bwiding <br />Squ2re Footage (II resid tial n�onslruclion, remodel or a' lihon) <br />' M m�r o�evices (If low voltage) <br />�� Description ot Work lo Be Done. Z DO ��`�7" <br />I <br />� CITY OF EVERETT LOCAL SAIES TAX CODE IS 1105 <br />C�y <br />cay <br />�uN, ll <br />st. te2�p �2 s 3 J onc <br />(.Jft �1�5�3 (s1�-92Sff <br />Stale2�p <br />Phone <br />C�y of Evere�H B� ess L�cense NumCer (reqwretl) <br />� �I�SO �O <br />CoNract Pncf ot� Uo�L � ( �1 t l � � Z 8 v <br />-} rL c`t �/ 4 1 "i- - <br />�'�l.G�.cc�'f��c ��/4�taa• C`�'� -- <br />ontact PersenlConlact umhedEmail <br />L�(fL�C� <br />f horo6y cortdy fhat 1 have read and exammed (his apphcaGon and know fho same to be frue and <br />cortect All prov;srons o!laws and ordrnances goveming this fype o! Hrork will be completed <br />�rhelher specrfied herein or no! The g�anling ol a permd does nof presume to give aulhonty t.: <br />v�olafo or cancel the provisions o/ any o!her sfafe or bcal law regulatmg consfrucfron or fhe <br />perlormance of consfrucfion fiaf ! am authonzed 6y fhe owner of fhis proporty (o perfomi fho <br />�tiorN lor which applrcation �s made and / comply �mfh the Slate Confraclors Law 1B 27 RCW acd <br />l.�t�G�-r� �-- <br />FEE <br />� So. 0fl <br />PERMIT# <br />E i5�o -i6/ <br />