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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C[DAR STREET, EVERETT, WA 96201 �� `�y <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org / ` <br />� �,, / Uo i '-003 <br />-� = I 7 I� � �� ,� n i� 7� V P��e`� <br />PROJECT ADDRESS <br />o�v��� <br />Tenant <br />�.� �/'_ �_ � <br />Ida�l Address <br />Ida�l AOtlress <br />c��Y <br />Cny <br />Stdle2�p <br />sia�erz�p <br />yzs-a��_ <br />�7 7 <br />Phone <br />Phone <br />�� n �, � �' � ��z� --E �I� I �a a i <br />EleclricalConlractor M11a�lAdtlress C�ry S+.ate2�p Phone <br />Slale License Number <br />Proposed Use of 6uildi•�g <br />Square Foolage Qf residential new <br />Fiumbe� of dewces (If low vollage) <br />Descriplion of Work lo Be Oone: <br />remodel or addition) <br />J <br />Contract Frice of Work <br />Conlact Person (Plan Review) <br />� SI��,c�s�Cer �� �6 <br />F[E <br />CI'fY OF EVERETT LQCAL SA! ES fAX CODE IS 3105 �i j� � <br />I heraby certdy lhal 1 h�ve read ,and exarnrned this applica(ion and know Ore sarne (o be 6ire and J v <br />corrneL All n�ovis�r. ns o(la�vs and ordinances goveminy (his lype ol�vo�k �vill be coa�plefen -- <br />�vhelhei spec�(eJ �herein or noL The granting o/a permit does nof pmsume fo yive authonly (o PERh1IT� <br />vialale or c�ncel the provisions o/ any olher slale or local !aw regulaling consfruction or the <br />peAomrance of conclmction. Tha( I arn nuthorized Gy fhe owner ollhis property lo perfomi Ihe E�' �Q I_ O/) 7� <br />work lor which apphca!ion is made and I cornply wilh (he Stafe Contr�c(ors Law 7827 RCW and �v <br />295.2J0 WAC. <br />�l c��, , r �l <br />,:E��,,Eo -:�w„ <br />�— - — <br />