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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 —v�n�nv.everettvda.org <br /> 1 <br /> �'�02 -� SiI�FLnp Lti <br /> PROJECT ADDRESS <br /> Q yp� L�T` �da�l AEdress City StafelZlp Phcne <br /> Tenant 1�1ai1 Address City Slaleilip Fhone <br /> ����� `�H�EP � 138 L13zo NGfk �rSl.v (il�,�,�u� G)q ?-°�' �So /95"fs <br /> ElectricalContractor Ata�lAddress City State2�p Pncne <br /> 3���5� qzy 3r� <br /> State License Number(required) City of Everetl Busicess License Number(required) <br /> — �� 500 ------ --- <br /> Pioposed Use of Building Contracl Price of 4Vork <br /> Square Footage pf residential new conslruclion, remodel or addition) Contact Person/Conlact NumberiEmad <br /> Number of devices(If lo�v vollage) <br /> �n�5y�l� /U2�v �zSA"`p �{/L�Tf2 /'�uiS� <br /> Descriplion o(Woik lo De Done: � <br /> �41 v� �J 6 <br /> FEE /�,� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 y �� � wj <br /> 1 hereby certily that l have mad and examined lhis applicafion and know the same(o be tn�e and <br /> cormc(. All provisions o//aws and oidinances goveming fhis type o!�vork�vill Ge completed <br /> whetherspeci�ed herein ornoL The yran(ing o(a permif does not presume fo give aufhonty to pERMIT;t <br /> violafeorcanceltheprovisionsolanyotherslafeorlocal/a�vmgulatingconsfruclionorthe r ��`� l� 1^(� <br /> pedormance oI constrz�cfion. That 1 am pzed 6y lhe o�vnerol fhis properfy fa peAonn the C u�� � � � <br /> woric(or wh' ion is madc I wtfply with fale Conirac�ors La�v 18.27 RCW and <br /> 2QC>-?0 'NAC. � <br /> � �/- Z 9 - / <br /> Signalure Date <br />