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ELECTRICAL PERMII' AP�LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE7, EVER[TT, WA 982J1 <br />425-257-8810 - FAX425-257-8857—w�r,v.evoreltwa.org <br />2 Z�z.. I vi2���u�a ���zr� <br />pROJECT AGDRESS <br />Owner <br />Tenanl <br />Sl�f+�f � <br />hlail Address <br />Ma1i Address <br />Po -z �/ 8 s <br />City <br />City <br />L� 2 �( �l s <br />� i��. ��SS <br />Staiel7ip <br />StatelZip <br />fhonc <br />Phone <br />yzs -�i5� <br />C%��� /� L��i2�c �2Jc, `/N�uwoell GUfi �J�n56 S33$ <br />EI^elricalConiractor MailAddress Qty Siate2�p Phonu <br />� ✓/�// � Z � ��l z. bN <br />Slale License Number (required) <br />Si`t� l� �G9��^IL'I <br />Proposed Use of Building <br />r-/5-� sQ r r <br />Syuare Foo�age Qf residential nc�v wnslruc(ion, rcmodcl or addilion) <br />Number of devices Qf low vollage) <br />Cil— y�ere��essC��License Number (required) <br />_���0.— _ <br />Contracl Price of Work <br />2 66 <br />I�rtn,n�, C��i( 994-�i�s_ <br />Conlacl PersonlContacl NumbeilGmail <br />Description ol Work lo Be Done: _��_S %!�� �!2 S l`�!�"� 0� 1� L d�'t s� �'7! J� H_ <br />�%F-i 2 !� _ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� <br />1 hc�eby ccrlily (h,�l l h�ve rcad and examined Ihis npplicafion and know fhc samc l0 6c frue and <br />r,orrecL �/l provisions ollaws and ordinances go' aming (his lype of wo�k �vill Ge completed <br />�vhefhr.rspecified herein or nof. 1he granfing ol a penni( dnes nof prrs�urir, fo give aulhority fo <br />vrolate orcancel the p�ovisions olany ofher sla(e orlocalla�v regulafinq consfruc(io^ or Ihe <br />per/om�ancc o/ consGur.(ion. TJraf 1 am aulhorized by Ihc ownerollhis property lo pr.donn (he <br />work lor which applicafion is madc and I r.omply �vi(li (hc Sfate Conliacfors Law iB.27 RCW and <br />2962�/' — ----- <br />��'`� � l �i — - —G� ��—� � <br />9naWre Datc <br />FFE <br />��� <br />PFRh11T# <br />E ( �� �--� � S <br />