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ELECTRICAL PERMIT APPLICATION <br />CITY OF cVERETT PERMIT SERVICES G �a I-►3 <br />��00 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org G i 3Ob-� 5Q <br />/°D/ ����� � ��e . <br />PROJECT ADDRESS <br />Tenant <br />Electrical Contrector <br />�� /.�� � ��,�, � <br />hlail Address <br />Mad Address <br />zL L�� �y�� ,,�1�� S <br />Mail Address <br />S���c��/qi� 4� 4' — <br />Stale License Number <br />� C' %J �'�'! C � <br />Proposed Use of Building <br />Square Footage Qf residenlial new consiruction, remodel or addition) <br />/ .�'� �✓ �-5.�; f <br />Number of devices (I( low vol�age) <br />u <br />Ci�y <br />Ci�y <br />�U�.3y�3 �3�� <br />�,�� C�✓.%� <br />Phone <br />State/Zip Phone <br />L Z� <br />City State2ip y2s.-�g).37� % <br />fiC��� ���, <br />Coniracl Price o1 Work <br />Contact Person (Plan Review) <br />GTY OF EVERETT LOCAL SALES TAX CODE �5 3105 <br />1 hereby . ertify fhat I have road and examined thi, application and know the sarne fo be We and <br />correcf. All pr�visions o(Imvs and ordinances yoveming this type o/�vork �vill be canpleled <br />wGethcr specificd herein or noL The granfing ol a permit does nof p�esume to give authonty (o <br />violate arcancel fhe piovisions ol any ofhersfate orlocalla�v mgidating consfn�cfion orfhe <br />peAonnnnce ol onsfnic(ion. That I am autho�ized by the o�vnerollhis property lo pe�fonn fhe <br />�vmk lor which;�pplication is mdc mid 1 comply wifh fhe Sfa(e Confracfors La�v 78.27 RCW and <br />296.200 WA <br />� ,^ ,__�__ ,� <br />�, -Z�—/� <br />nn�;se� �: o�n <br />FEE <br />����� <br />PERMIT# <br />EI�O(� - I���I <br />