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ELECTRICAL Pt=RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 982Q1 <br />425-257-8810 - FAX 425-257-8857 — vnw✓ everettwa org <br />i� 1� Iti.�-f�'b �f � a J F <br />i PROJECT ADDRESS <br />Ovmcr <br />Tenanl <br />t.tail rYCCresS <br />Idad Address <br />� <br />Cor,trador �da;l Address <br />V� Vrti(/ f39� �Z- <br />Sta;e Licer.se Number (required) <br />I PwPosed Usc uf �uild�ng <br />G�� <br />Clly <br />Ci;y <br />����a...o21 <br />� �-I D" �5 <br />q�2a ��us <br />si,��,z�P -- <br />5�a!e�zip <br />siate�z�v <br />I�n,ne <br />PhC(^ <br />/03�%�� <br />��.��•� � <br />p¢52/,� <br />City of Fverett �uslness License Num6er (requved) <br />!?'� El�_ 0.J __ <br />T <br />Coniract Pocc ul Work <br />Sauare Footage pl residential new conslrucUnn, remodel or addifon) Contact Persen'Conlad Number/Ema�l <br />Number of Aevices (Il lov+voflage) <br />Se< <-� Q � �� <br />Description of Work Io Be Done�. �� /IS{4 ��G' 7�p/� d" /�f�✓ ' Q���� �G nf � <br />I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I horeby ce�hly that I havc read and eu�m7ned Hus appllcn�ion and know the same to he true end <br />correcl. All p�ovisions ollmvs anAord�nances goveming fhis �ype ol �rork �:dl6e completeA <br />�:hcfhcrspcafied he.ein or no(. 1 hc nranting eI a permif does nof prnsume fo gire aulhonlylo <br />violale or cancel the provisions o7any other sfafc or /or.al law resufaliny cans6uc'ion orthe <br />peAormance ol consfruclion. 7haf I am aufhonzed hy (hr, o�rnerol this properfy to perfonn flre <br />u•ork lor �.�hich applicatien is made ,�nd I cornply with (he Stafe Con(rar.�ors Ca�•� 1827 /?CW and <br />ri�l�,.�i[::nG i.:^'� <br />FEE <br />l�U�' <br />�PLRD1iT-", <br />E a (So Z-� <br />