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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE (, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereilwa.org <br />S z l (�"�"o � /}�.. <br />PROJECTADDRESS <br />Owner <br />Tenanl <br />�L� <br />5Z� u�� � P'1 <br />Pda�l Addiess <br />MadAtldress <br />Elec�ncal Conlractor + hta�l Atldress <br />S IT I� ESE`6fSo �Q <br />State License Number (required) <br />�� <br />Proposed Use o1 Building <br />�- � v<��t� v�l� <br />City <br />C�ty <br />/�,,.�.. NL"�; k G -3�3 �lo <br />Square Footage (If residen�ial ne�v consirudion, remodel or adddion) <br />Number ol devices (If low voltage) <br />Cdy <br />State2�p <br />�._► 5 - I � <br />[-1�(0g-�'l <br />- $xl - 6�)3 <br />P�one <br />Statr?�9 hone <br />(Llz � <br />: :Ji} 9�z71 LyS-7, <br />SIatMLp <br />Phone <br />p�►��,� <br />City of Everett Bus�ness License Number (requiretl) <br />Contracl Price of Work <br />Contatl Person/Contact NumbedEmail <br />w" zaq-,� c� ���,�I- ,, Q�.�.,���� n� K�� �,� <br />Description of b'Vork to 6e Done�. I �_ <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />1 hereb}� certily fhat 1 have read and exnmineAfhis application and kno�v the same fo be f�ua and <br />canect. �lll provisions ollmvs and ordinances goveming fhis typc ol worN �rill be cornpleted <br />whefher specdied herem or noL The granting ol a permd does not presume fo 9ive aufhonty to <br />violate or cancel fhe prowsions ol any olher sfafe or local law �egu/ating consWction or Uie <br />peAomiance o( consWclion. Thaf 1 am aufhonzed by fhe owner ol (his propeRy fo pedomr the <br />ivork Ior which application is made and 1 cornply wilh fhe Sla(e Conhacfors Law 78.27 RCW and <br />296.200 WAC. /I � <br />,.rr/ .// ' ../.. /. . <br />kEV15ED OB96901i <br />FEE <br />50 �� <br />P[RMITiJ <br />i E I o� b�( <br />