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ELECTRICAL PERMIT APPLICATION <br />CITY OF E\!ERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www everettwa org <br />3>v � ��t��re.. �,�e £✓ev��f� cJi� 98� <br />PROJECT ADDRESS <br />Or+ner <br />Tenanl <br />Idad AdOress <br />fdatl Atltlress <br />Cny <br />Ciiy <br />1 T� �IeGTr'i c I�oly i9� �✓� S� s�. <br />Elettncal Coniraclor k7ad %�doress Gty <br />State License <br />Proposed Use ol8uildmg <br />Square Footage (If residential nev+construdion, remodel or addit�on) <br />Nurnber of tlevices (Il low voltage) <br />State/Zip <br />State2m <br />i a -�o- i3 <br />C-i3rz--i�G <br />3,,s�� _ <br />: ontract Pnce of Work <br />Phone <br />Phone <br />��sy�e <br />Phone <br />Contacl Person (Plan Re new) <br />Descnplion of Woik to Bc Donc, ��4'�/ ��r��e ----- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certdy that! have read and esamineU fhis applica(ion and know the sarne (o be fn�e and <br />cor�ect. All provisions o/ lan�s and ordinances goveming this type o/ wmk �vdl be cornple(ed <br />whether spec�hed herern ornoL The gnnting ol a permif does nof presume to g�ve aulhonly to <br />v�olafe or cancel the pr isions o! any olher state or local law regulahng cons(iucfion or Ihe <br />peAonnance o� cor c(ion Thaf 1 am authonzed by Ihe ownero( this property fo perlorm !he <br />ivolfr !or which 2�6cation is made and I compty �vdh the Sta(e Confraclors l.a�v 78.27 RCW and <br />296.200 WAC j <br />2-30-/3 <br />FFlo5E0YrOn] <br />FEE <br />��'� <br />PERM[l k <br />E i��a- iK� <br />