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ELECT�CAL PERMIT APP�ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.gov <br />'� 453 � S�A111�4��_ � <br />I PROJECT ADDRESS <br />��D\�i.1 �M�S4t� la u 1 i i� 1'� p� �1E LI� m�l'�.iS wA l��-5� _ <br />�� Owner MaJACdress C�ry Sta���n <br />3l� 322= 1u'�� <br />iTenant Mad Adtlress Crty Slate2ip Phonc <br />': tr, a.�_i. rn.h-.e. 1�G, rv►�i �tF,7,� 4��er.�F, �G f�A=�f1��n,A-�'1��1��i� �'1Lrii'I-�C <br />� ElectncalConlractor MauACGress <br />gL�a-OE�va i�lP <br />Slate License Number (required) <br />��S��G�cr�hal <br />Proposed Use ol Building <br />Square Footage (If residential new <br />Number of devices (If low voltage) <br />Gry <br />SlatelZ�p <br />Phonc <br />1��4�3"1 y <br />Cdy of Everetl Busmess Lice�se Number (requved) <br />��'� � �a�� <br />Conlrac� Price of Work <br />�-�,�ITi,, a-�1�- `-h.s - 3 Z�-2�vo� <br />remodel oi adddion) Conlad Person/Contad NumbedEmail <br />�1°�ttA�.1 @ H�� C USr�rn. Ctn <br />Descnption ol Work lo Be Oonc. �.v� � 1' JI�+LV I� �l��i <br />CITY OF EVERETT LOCAL SALES TAX �ODE IS 3105 <br />1 hernby certdy fhal 1 have read anAexammed fhrs appGcahon anAknow fhe same fo be tme and <br />wrrecl. All proviswns ol laws and ortlir�nces govemmg Ihis type ol work wdl be complr.ted <br />wbetherspeci�ed heicin ornol. Thc gr�.rtmg o! a pennrt does nof presume fo g�ve authonty fo <br />violate or cancel Ihe provisions o! any ofher sfafe or local law regulahng consWction or fhe <br />pedonnance o/ ronsfruclion. Tbat 1 am aufhonzed by fhe owner o! (his property lo peAorm Ihe <br />work lor which applicafion is rnade and f compty wdh fhe Sfale Contraclors Law 18.27 RCW and <br />296200 WAC. <br />� �:� � 'L41 � �5 <br />� nature U tc �� <br />arvrsm asowza �. <br />FEE <br />� �l5 ,°� <br />PERMITJI <br />E 15 I 0— c� 0� <br />