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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 - FAX 425-257-8857 — www.evereltwa.gov <br />Ji�l(� �1����l�i-�h �uP . -��i� '� <br />PROJECT ADDRESS <br />2� <br />Tenant <br />rnan <br />Mail AtlAress <br />ConUador Mail <br />E�z ��c��y� <br />State License Numbe� (required) <br />PropoSe��ILY` <br />Square Footage (If residential new consiruction, rernodel or <br />Number of .�Pvices pf low vollage) <br />Description of Work �o Be Done: <br />CITY OF [VERETT LOCAL SALES TAX CODE IS 3105 <br />c�ry <br />Cify <br />g—a��15 <br />C �5o�—Ibs <br />��� ��$l.vS <br />StatelZtp 2 � - ���Ph��� � <br />S�ate2ip Phone <br />�� z�� �i��������� �zZ,� <br />City �_ tc2ip Phone <br />�7y tn .S� l� 3�0 -U`� -�o. <br />Ciry of Everell E3usine, s Li nse N erdr�a uired) <br />��s— VVD���— <br />Cont a•1 Price oi Work 1 <br />7 �<�� kY��c��e <br />Contact ersonlContact NumbedEmail <br />3l�' � ' `� �' go �v <br />�)1X r�a(�(� aiL�i� �-�Ll�Vl��dl . � <br />f hereby ce�}ily fhat 1 have mad and cxamined (h1s applir.alion and know fhc same lo be truc and <br />cormcL All prpvisrons ollaws and orclinances go•�eming Ihis type ol �rork wii! be complefed <br />whelher spedfied hrrein n� not The gr+nting oI a pemiit does nof presume fo give authoiity to <br />vmla(e or canccl the provis/ons o(any other sfate alocallaw mgulafing conshur.fion o� fhe <br />peAormance o/construcfion. That I am auUionzed by Uie owner o/ffris property fo prnorm the <br />malc lor which applicafion rs made and I cornpty with fhe Stafe Confracfors La�v 18.2/ RCW and <br />ree <br />��5, �i <br />PERMITJf <br />E I ��S' I (.�S <br />..o-. — . � .R-i_::�.v �� :�.,-..-,n�..._. _ .. .�... ._..._s_.. .. .....� �..__..._.. <br />.�-.�.,.�...r.-. r.-..� �r+. �...: �. <br />..� .:_9t,.....r.. _.- ..._.:a.�:.� ........_..""'.__.._.." _._.�.:.._ __.. ."'�_ ._ ..."" <br />HCVI�L D OtlNM120IJ <br />