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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org f/—�� �� �� <br />G � �(�/ �� <br />�sz�z �z�,o� <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Electiical Contrador <br />Mail Atldress <br />A7ail Adtlress <br />MaJ Ada�ess <br />�k �D�t < f ��-� �-/� <br />State License Number (requiied) <br />� -- <br />Proposed Use of Huilding <br />Squa�c Poolage Qf residenlial new constiuction, remodel or addition) <br />CAy <br />City <br />a3� <br />�� -� <br />Statel7.ip Phone <br />StatelZip � /� Phone <br />���� <br />Stale2�p Phcne <br />Cily of [verett Business License Number (requir� <br />� — /D ��L� —� <br />Conlract Price of Work <br />Conlact PersoNContacl NumbedEmad <br />Number ol devices pf low vollagc) <br />Descriplion of Work to Hc Uonc: �����{/�/V�i�!-VIb — <br />CITY OF EVER[TT LOCAL SALES TAX CODE IS 3105 <br />I hemby certdy Ihnt I havr. �end ,�nd e+arnmr.d this apP��ca6on and kno�v the 5ame (a be f�ue �nd <br />conecf. �ll provisions ollaws and ordinanccs govrming fhis lype ol work ivrll br, comple(ed <br />�a�hefher specrlied herc�n or not. 7fm. �ranfmy oI a penmf docs nof preswne fo yive aufhunty lo <br />vrolalc or c�nccl fhc prowsions o! any ofhcr slalr, or lor.rd law rr,gulafing constnir,fwn or Nie <br />pe�lormancr, o/ conshuc'ion. Tha(1 r�rn nufhonzed by lhe owner o/ fhr.; prope�ty fo per/onn Il�e <br />�,,od� �or�vmr.n a�n���, on is madn, artd I r.ontply wdh fhc Sfafe Confraclors Lar✓ 78 27 RCW nnd <br />296 200 WAC. <br />�---- — �� - �� - - ------ <br />u e .Ie <br />rrr yhro nomnom+ <br />r-Ee <br />SO �� <br />� <br />P[RMITN <br />E I �((/_ osd <br />