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ELECTRICAL PERMI�" 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 />L�'I �1 � �G� � �e <br />PROJECT ADDRESS <br />Owner <br />eff' 9/� � ��k'e� �e <br />hlad A�dmss <br />Gry <br />Staie/Z�o <br />ia-la--�l� <br />C l�//li'd �� <br />Zo 6- 9 /S- 3 <br />Phone <br />Tenant IdailAtldress City SlatelZip Phone <br />�(,'U Vl e-1 - <br />Electncal Coniraetor �Aa�l Address Cay Sta�erz�p ano�e <br />Slate License Nwnber (required) <br />�t' S�'G��17 C E <br />Proposed Use of Budding <br />Square Foolage (II iesidential ner� conslruclion, remodel or addition) <br />Number of dzvices Q( low voltage) <br />City of [verett �usiness Li[ense Number (reqwredl <br />Contract Pnce cf Work <br />Contact Person�Conlact NumbedEmail <br />� —�✓� �__.___ <br />Descnption ol Work to Bc Done' � TZL �I � v�( e� ( �� v 1� e" <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS 3705 <br />1 hemby certily lhaf I Ireve mad and examined fhis applicafion and know Ihe same fo be We and <br />correcL All prorisiwu ollaws and ordinances govenring this rype o! work will be comp/eted <br />whelherspec�ted hercin or nof. lhe granfiny o! a pemiif Aoes nof presume fo give aufRonty (o <br />violale or cancel the provisions o( any olher stafe or local law rrgulafing consfn�cfion or fhe <br />pedonnance o! construcliov Tha( I am authonzed by the o�vner of fhis property fo perfomr fhe <br />wn�k tonvhicA applicv(ion r,: made and I comply wilh (he Sfafe Confracrors La�v 78.27 RCW and <br />296.200 WAC. <br />REI'6EDC6O6^.O�i <br />FEE <br />50 0� <br />PERh11T� <br />E l�lO-�B <br />7zz <br />