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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 - www.everettwa.org <br />� <br />/i .,l � � <br />PROJECT ADDRESS <br />i <br />� � �� � ,� �� ��� � <br />���;��iHT�v�'�_ ,.. .`S <br />Owner tdail Address <br />Tenanl <br />Mail Atldress <br />;� i: <br />�J C_ /..�.1rr��o,� i�C.�=��,—('�c �N� <br />Eleclrical Contractor Mail Address <br />n <br />�� �, J�; = l f. i 0 s. .. ,�; C_ <br />State License Number <br />, r <br />Proposed Use of Building <br />� - <br />'iCu <br />Square Fon�age Qf residenlial new construction, remodel or addilioo) <br />Number o( devices (If low vollage) <br />Descriplion of Work to Be Done: '^� ��' -" f J�" `"� <br />City <br />City <br />L7, <br />Ciry <br />cJ SIr <br />Slate/Zip <br />StatrlZip <br />Phone <br />Phone <br />_o <br />y�l ()� ( zJG—�� `,^� �. c `I i i <br />State/Zip Phone <br />Conlract Price of Work <br />Contact Person (Plan Review) <br />FEE <br />• Ci17 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 (�.��� -� <br />1 hereby cerfi/y that I have rcad and examined IDis application and know lhe same lo be true and <br />conec(. A/l provisions ol la�vs and o�'finances gavc-rning this type o/ wohc will be cornpleted <br />whefher speci(ed he�ain ornoL Tne gianting ol a pemiif c"�es nof presume fo give aulhonty to PERMIT.N <br />violate orcancel the provisions o/any o0iersla(e orlocal law regulating constniction orfhe r�� ^,t V��� <br />peAonnance of cons(n�ction. Tirat I am authorized by fhe owner ol fhis property fo pedomi fhe C �J L� <br />v;oik for which applicafion is rnade m�d I compty �rith fhe State Con(ractors Law 18.27 RCW and <br />296.200 WAC. , <br />%! — a , � <br />/ �'_ /�,_ �-L-; i <br />� �....,.�.,... Date <br />�.._.�,..,��� <br />