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ELEC�ICAL PERMIT AP�ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—wv✓w.everepwa.gov <br />i�� I � l�l�����,�an ��uP .-U� i-� f4 <br />PROJECT ADDRESS <br />Tenant <br />l.7ail <br />hlail AtlArr.ss <br />Contractor Mail <br />t�zT�co ��{�� <br />State License Number (required) <br />Yn�ic�..�i��,�l <br />Proposed Use ol Bullding <br />SQuare Footage (If residential new conslruction, mmodel or addition) <br />Numher of devices (If low vollage) <br />Oescription of Woik lo Bc Done: --�����_4—Y <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br />� S�alelZlp <br />SIa1c/Zip <br />�7y l� S� l9 <br />2 � -1-1�{Ph��11�7 <br />1'honc <br />Phone <br />3�0 .U'-i,') -�o <br />City oi Everelt Busine 5 c�ns�Number�ired) <br />� �r��-�-- <br />Cont a � Price of Work <br />r � <br />Contact eisonlContad NumbedEmail <br />.�lf 0 ' `.� 1' �p �ti <br />j�,Y r�t �� � c.�� � 1����-��d,l .� <br />1 hereby ce�fity tha� 1 heve read anJ examined thls application nnd knorv the same fo be bue and <br />conecL All prpvisions of laws and ordinances goveming fhis fype oI work �vill be complefed <br />whether specfied herein ar noL 7he grenfing ol n permi7 does nof presumc to give aufhonty �o <br />violate or cancel the provis/ons ol any ofher sfafe or local /a�v mgulaling conswcfion or the <br />per/omrance ol consWction. That 1 am aufhorued by fhe oivner o!lhis property fo perlonn fhe <br />a�ork lor which upplienlion is made and 1 compty with fhe Sfate Confractors Law 78.27 RCW nnd <br />296.200 WAC. /� <br />L <br />FEE <br />� �5 00 <br />PERMIT# <br />E I�bg-11�� <br />:.,r,. ,....v___�,.__ :_u�_.____ _..:_�..._.._.__..,. .-. _. ..-- --__, _.. <br />kFwsm onmrtao �+ <br />