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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �_ 2�3 <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org C i3 b�� <br />',�;; �I � ,�- <br />PROJECT ADDRESS <br />1-+r,��� ; 151=��., <br />Owner <br />Tenant <br />��i(,� )V�. , �� <br />Electrical Coniractor <br />ay <br />�'����r}=l i9+b�l�-� <br />State License Number <br />Proposed Use of Building <br />��j '� ;�rn ��� <br />Mail Address <br />Mail Address <br />Mail Address <br />Square Footage Qf residential new wnstruction, remodel or addition) <br />Nuinber of devices (If low voltage) <br />I, Description ot Work lo Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />StatelZip <br />StalelZip <br />Phone <br />Phone <br />�-� �, :, S �)15 c� 3 r G1 <br />Ciry State/Zip Phone <br />� � � <br />CoNract Price of Work <br />Contact Person (Plan Review) <br />I hereby certify tftat I have read and examined tltis applicafion and know the sante to be tnie and <br />conect All p�ovisions oflaws and ordinances goveming Ihis type ol n-ork will be cornplefed <br />�vhefher specified he�ein or not The g�ar.ting of a permil does nof p�esume fo give aulhonty to <br />violate or cancel fhe provisions olany other state orlocal la�v regulating construction or the <br />perfonn3nce o(constnrction. Thaf I am aufhorized by (he owner clthis property (o pedomi fha <br />�vork lor �vhich applicalion is m�de and I compty u�ilh !he Slale Contractors Lmv 18.27 RCV:'and <br />296. �OO WAC. „ i . . <br />.....��.��:ec:i� <br />FEE <br />� �i � �% �-'1 <br />PERMITli <br />� ( � �; � - C)�'`7 <br />