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ECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wv✓w everettwa org <br />i��lo �5��7�-��,es� .9-�� <br />PROJECT ADDRESS <br />.� J�,.� , <br />Owncr <br />Tenant <br />Electrical CoNractor <br />I:tail Atldress <br />67ad Address <br />Idad Aadress <br />�'iaF/�S�? � i 9 ' o �-ti7 — <br />Stale License Number <br />Ipioposod U e o� 6uiltling <br />I i+- GJG�c� <br />�� <br />I Square Footage (II residenual new conslruttion, iemodel or addtlien) <br />�'�' <br />Numbcr of devices (II lovi voita9e) <br />Oesaiption of Woik to Be Done� � <br />� <br />�=�3�-�V <br />6..�-g-�3 <br />� rz � i,t/� �� �: <br />Gty Slatc�Lp <br />C�ry State/Lp <br />Cny <br />State�Z�p <br />Pnone <br />� <br />Pnone I <br />�%7/�i ' � �i fy <br />Phore <br />� ' <br />S �Oa . i <br />Corntract Price of Work I <br />�`�=�- SA1�u�'� <br />Contad Peison (Plan Revieer) <br />(/2:`J ZyPJ g�71� <br />,�o o R- <br />FE ��5 oc� <br />CITY OF EVER[TT LOCAL SALES TAX CODE IS 3105 � <br />1 hereby certify fhnt I have rrad and eeamined fhis applicafion and know (he sarne lu he 6ue and _ <br />co�cL All Provisions ol laws and ordinances goveming fhis fype o! �rork �vi�l be complefed <br />�vhefher specified hemin or noL The gr�nbng o�.� permrt docs nof pmsume fo give authonty fo PERFIIT�? �I ( <br />violafe or r.anccl Ihe provisions o!, ny ofher sfale or local la�v rcgulafing construcfion or fhe r I��/_ , <br />vo k!or �vh ch appl c f or'ois �'de and�lr ormpl} ��ff fli'e SfalecC,onfractors La�v 78?7 RCW'anA C "J <br />296 200 W�1C <br />�-- <br />_� .� , /� ,�. l. �. <br />�tv�:eorrn�, —.--�_------ — ---------------- - -�-------� �—�-- <br />