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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 _ 17 _( S <br />425-257-8810 - FAX 425-257-8857 — vAm.evereltwa.org <br />soa -1D <br />2-22q VlArnoli <br />AVL Ev�rr�lf w,fi <br />9gZD( <br />PROJECT ADDRESS <br />ChriSOpLer <br />�Arion 7-2N LA/e+wterc A'e &"'Cf+ <br />0( q,5-74f-�� <br />Owner <br />Mail Address <br />C r: <br />State!Z,p <br />Phone <br />C11ri71dvnrr r><sn <br />Tenant <br />9 N/e4 xec AyL <br />Mail Address <br />Eve, +4 <br />Cry <br />b✓l��`�ff261 <br />Slate'Lp <br />`�zs-74�-$v <br />Phone <br />T lVjElrc�l nt <br />CIry lto'/yWJ AL16 W <br />Src.Mr <br />Z06-613-w <br />Electrical Contractor <br />Nail Address <br />C 4 <br />Stxi Z p <br />Phone <br />IJORTNE5 �5-7�I✓AA <br />Slate License Number (required) <br />1rcl,.1/._ f;cn o+ _C cr�lot f V GAre-, <br />Proposed Use of Building <br />MCA, (,r s f0f6 1 316, 7� <br />Square Footage (if residential new construction. remo I or addition) <br />I & 6 r YV Ll //c y <br />Number of devices (If low voltage) <br />D51 Z5 <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />1b- r> + Ti.rncr zOG'G18 GCZZ�6rc�@nW <br />Contact Person/Contact NumberfEmail 'naf <br />Description of Work to Be Done � g xTfc K T-TZ70 — NE 270 t&/ S <br />X lrl<LE/�rK) �1cla Mkl.<% :que' irr <br />Sb4ri, odo <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 % ro <br />1 hereby cerl that 1 have read and examined this application and know the same to be true and ' <br />correct. All provisions of laws and ordinances governing this type of work will be compteted <br />whether specified herein or not. The granting of a permit does not presume to give authority to ZE602-- <br />IT # <br />violate or cancel the provisions of any other state or local law regulating construction or the /D3performance of construction. That I am aulhonzed by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RC W and <br />gon Pn0 WAC. <br />,roe <br />REVISED OWW"r" <br />