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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 <br /> � �0( �vc.{2�/' � <br /> PROJECT ADDRESS <br /> ��Orr'J <br /> Oemer MailACaress C�ty Slate�7_�p Phone <br /> � <br /> I <br /> TenaN tdail Address Ciry StatelLp Phone I <br /> In� �x�����t �G`1ZS 9� �C...IF �1��f �� r�zs� (��z3y-o6i3 <br /> Electrical Conlractor hlail Address C�ty SlatelZ��p Phone <br /> 1/��H-ov�s �'SZa G <br /> Sla e License Number(required) City of Everelt Dusiness License Num6er(required) <br /> 1700 ; <br /> � <br /> Proposed Use of Ouilding Conlracl Price of Work ' <br /> I <br /> �� Square Footage Qf residenlial new construction,remodel or addition) Conlact PersoNContact NumbedEmail I <br /> I <br /> Number o(devices Qt low vollage) <br /> Descriplion of Work to Be Done: � "� `�`�_ I <br /> / p I <br /> I _ - <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��� vO <br /> I heJeby certily fhaf 1 have rcad and examined this appiicalion and know fhe same to be Irue ard <br /> correcf. All provisions ol laws and ordinances goveming this(ype o(work will be complefed <br /> I �rhefher speci(ed he�eirr or noL The gran(mg ol a pem�it does not pmsume to givc au:honty to PEKMIT# <br /> viola(e or cance/!he pravisions o/any otherstafe or local la�v regulating constn�cfion or fhe � I � A I _ O I C <br /> pedonnance o/construction. Thaf I am au(horized b}�fhe owner ol fhis property fo perfonn Ihe U � <br /> �vork for�vhich applica(ion ia made and I compty�vilh fhe Sfate Confracfors Law 1827 RCW and <br /> 296.200 WAC. —� <br /> �/�//� <br /> Signalure Date <br /> a=visFn aece�ou _ <br />