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--- �--------- - � - -- --� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET. EVERETT, WA 98201 <br />425-257-88t0 - FAX 425-257-8857 - vnvw everettwa org �� _D7—/�j <br />C�3��`l�7O <br />Gl� ;� �in� � inL <br />PROJECT ADDRESS <br />i Owner <br />Tenant <br />tdaii �diress <br />'rta�l ACC�ess <br />ConUac�or - hladAaJress <br />�- �.� � n� '��`7 G� � <br />� Li nse Number <br />�roposed Use of Buddmg <br />Square Foo�age (If residential ne�v consiruchan, remodel or addilion) <br />ol devices (Il low voltage) <br />Descnplwn of Work to Be Done <br />CITY OF EVERETT IOCAI SALES TAX CODE IS 3105 <br />Cdy <br />Gty <br />I..� <br />�,;Y <br />G <br />$�dlClZip <br />S�ate�Lo <br />Stzte2m <br />Comract Pnce ol �Nork <br />Contact Person (Plan Revievi) <br />1 hcreAy cerhly tlrnf I have read and eramined fh�s app6ca�ion and know Ihe samc lo be tnie and <br />correcl. All provrsrons o/ laws and o�dinances yoveminq lhis (ype ol �vork �rdl be complcled <br />whelher speci6ed herem ornof The gianhng oI a pemnt does nof presurne lo give aufhonty (o <br />violate o� cance/ the provisions ol any othersta(e or local law regulating consfnrclion or the <br />perforntance ol consfnic6en. That I am authonzed Gy tl;e or+ner ol thrs p�operty fo perfomi the <br />ivork lor u-hlch aPP��cafion is rnade and I compty vnlh the Srote Conl�actors Law 78.27 RCW and <br />296 200 WlIC. <br />FE1';SED 7�0'❑ <br />PnonC <br />Phone <br />�6� <br />PM1one <br />PEE <br />50� <br />� <br />PERMff# <br />EI31C�-O�O <br />