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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CL=DAR STRE[T, EVER[TT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - ww�v.everettwa.org <br />y72a W • V��W ��e _ . El,��'L�7T <br />PROJECTADDRESS <br />3 `u'i5 <br />Ei 5o3-a��( <br />�'�1E1� ,�R-s`'/��lR��G Bl�l 2�-z-oY•-� ST��k) E9M0(�iDS wA-_Y2�-"1�`i'-?b <br />Ovmef MailAddress Cily SI31e¢�p Pbone <br />Tenant MailAddress � QIy S�ate2��p I'hone <br />� c e�y L=� <br />Eleclrical Conlrac�or <br />Lic^_nse Number (required) <br />I��S f17C_'�'Y/ /-} L <br />opnsed Use of 13vi'�ding <br />Mail AJdress <br />Square Foolage (If msidenlial new conshuction, remodel or addltion) <br />Number of devices Qf Iow voltagc) <br />c�ry <br />StaleRip Fhone <br />Gty of Everetl Busii ess License Number (required) <br />CoNracl Ptir,r o( �Voik <br />Conlact Person/Contacl Numbedf_mail <br />Description oI Work lo He Done: �pj>_ er...J � L�_���c-��_ _G!1'��»L�D L� —V/��i � y._ <br />� . �j.�- Lor�-T/NG� <br />1,.��T„v�,��,-_��zs � _ �z��s,_�i�-�-- - <br />CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 <br />s <br />I hrvrGy r,erlily /haf I have n�ad ond examrned fhis applicafion and knnvi Ihr. sarnc In hr, buc and <br />conecf. /Ill provisinns o/ laws and orcfiwnces goveming fhis type ol work wdl be completr.J <br />�vhefher specified heiein ornoC The granfing o(a permd does nof presumr, tn givc aulhonty fo <br />violate orcancel the provisions of any othr,r sla(e orloc��l lav� rr,gul.�ling consfruclion or (h� <br />perlomranr,c nlcons6uction. Thaf 1 am aufhonzr.d Iiy Ihe ownr.� ol fhis prnperfy to perfonn thr. <br />wmk lor w. hich applicafion rs maJe anJ I r.ompty wilh Ihr, 5(ale Conlracfws Law 18.27 RCW,ind <br />296200 WAC. <br />- --- -----...— --- — - <br />Siynalurc Uatc <br />FFE <br />�,--�D� <br />P[R��11 T�l <br />E 1503 - oz� <br />l <br />