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/S� L/ - <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FA}:425-257-8857—www.everettwa.org <br />lsr �L - S,<-/ <br />� PROJECT ADDRESS <br />i <br />i � �� <br />i -+�a <br />Owner <br />� ��� <br />i Tenant <br />`1�, -rr-z, 5 <br />Idail Address <br />Idail ACaress <br />��5,,— <br />I ,Sz y-�� S' <br />City <br />C�ry <br />_ �✓-/ <br />C�Sol�a< <br />i --8—a S <br />�� <br />Slate/Zip L�Z� � phone <br />�l 4S 2 � J -3�� -�I � � <br />Slate/Z�p <br />Phone <br />a K�,s-� a� c�.���2 <br />Elecirical Conlractor �dail Address Ciry State/Zip Phone <br />State License Number (requiied) <br />2�.i 1 C7�4(S c�� `�- `/ <br />Proposed Use of �uilding <br />Cdy c( Everett Business License Number (required) <br />Con!ract Price of'rVork <br />`� �-,�•,-o� A�`Yt �'%Sv —T�/� L I Cj uo) <br />Squaie Footage pf res�dential new conslrudion, emodel or addition) Contact PersonlConlacl NumbedEmail <br />Number o( devices Qf low vol�age) <br />Description of Wark to Be Donc: � �-�`�- �5��`�"� `�" ��1�"q �� �S�U � <br />i �-N`lt��`.SL / — <br />C�TY OF EVERETT �OCAL SALES TAX CODE IS 3105 <br />I hereby certi/y tha! ( have read and exarnined fhis applicafion and know fhe same (o be (n�e and <br />corrnct. All provisions o/ lavis and ortiinances goveming fhis lype ol �vork will be comple(etl <br />whefher specified herain oi noL The grantin9 0l a permit does nol pm.sunrc fo give ac(honty (o <br />violate or cancel (Ire provisions ol any other sfafe or local lar� mgulafing cons(n�cfion or fhe <br />perlonnance olcons6uction. Thaf I am aufhonzed by the o�vnero/this property to perlormlhe <br />v.ork for �vhich applica(ion is made and I comply with (he Sfafe Gonfractors Law 18 27 RCW and <br />296.200 WAC. <br />C <br />RFYI$FU Od9E701.f <br />� <br />C�� ��Z " �S <br />FEE <br />r O� <br />✓� <br />PERMIT�1 <br />E►50[' 02g <br />