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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa org �a _,� �,3 <br />� i3iZ -�99 <br />i ��/� (,f�4/rtad" J�l� i%n� � Y3 <br />I PROJECT ADDRESS <br />Tenan� <br />�d,x�,�,�-�� <br />� <br />IAail Atldress <br />�da�l Adtlress <br />� Y.� ��C �J � /-GC fl 'L � i1C �, � <br />� Electric Contraclor �daJ Address <br />�o%��-��os-�h <br />Slate Lic ise Number <br />(�.e 5 • -fri D�eX J <br />Pioposed Use of �uild ng <br />t� <br />Square Foolage (If residenlial new conslruction, remodel or addition) <br />Number o( devices (If low voltage) <br />i IQ <br />; Description o( Work to t3e Done�. ��/�w L'� � v' <br />City <br />City <br />G�f"r <br />StatclZ�p <br />StatelZ�p <br />StateiZ�p <br />ftt`OD� <br />Contract Price of Work <br />Conl2cl Person (Plan Review) <br />/ �u <br />rnone <br />Phone <br />Phone <br />F[[ � <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 9105 �/ n� O <br />��� <br />1 hemby certdy (hat 1 have re��A and exanrined fhis applica(ion and know !he same to be (�ue and <br />conecf. AI! provisions ol laws and orzlinances governing this type al �vork will be completed � <br />whelher speci(ed herein or noL Thc gianfing ol a permil does not preswr�e fo give authori(y lo PERMITk <br />violale or cancel fhe prov�sions ol any othersfale orlocal law mg�doring constn�c�ion or the � I�(� —�T �� <br />peAonnancc o) consfmction. That l am aulfrorized by Ihe ovmer o! fhis property to pcAonn the � � <br />�vork lor which appOcation is nmde and 1 comply �vi(h Ihe State Confracfors Law 18.27 RCW and <br />296.200 WAC. , <br />ignaWre <br />I... r.eu_;r�i�c^_. _ . .. .._ <br />