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��z �. 25. 2015 8: 38AM <br />ho. a�s3 P. 2 <br />ELECT�TICAL PERMIT APPLICATION <br />CITY OF EVERET7 PERMIT SERVICES <br />3200 CEDAR S7REET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />��3�- � f�'�L SI.J <br />PROJECT ADDRESS <br />Tenant <br />Electncal <br />C�StiTb 5H`i'�U Y�• <br />State License Number (requ�red) <br />lQ� ir�e.t�;c�P <br />Proposed Use ol Building <br />tdail Atldress <br />Idail Adtlress <br />�dail Adtlmss <br />Squere Foolage (If residential new construaion remotlel or adtlilion) <br />Num6er of devices (I(low voitage) <br />C�ry <br />CiCj <br />Ciry <br />SlalelLp <br />Slalel7�p <br />Stale2'p <br />�I�c��s' <br />3 �a s�-� s <br />� 15� '��/ <br />ti �'- <br />Phone <br />Phone <br />Phane <br />Ciry ot EaereN 6usiness License NumCer (required) <br />$ I �z.o 0 <br />Contrac Price of Work <br />(icu.c,uti�iYllu.vl UT�—t5'L—�{4U'� <br />Contact Person/Contacl Number/Email <br />Description of Work to Be Done: S i'XY< <-e-- � �T�'(— � (i}: C�'�fS'S �S�dV1NP V� iYV � On�"' <br />CITY AF FVERETT LOCAL SALES TAX CODE IS 3105 <br />I AereDy cerfily thnt I heve ioad and ezamined 7his application and know the same lu 6e lrue and <br />correcL All provisions ollews and ordinances governing Ihls fypc ol work wi(I 6o completed <br />whefher spoUfied herein or noL The granGng o! a pormit does nof presuma to give aufAonty fo <br />viola�e or cancel tho provisions ol any ofher sfafe orlocal law regu/afinp const�ucYion or the <br />pedormance of consWction, rhat I am aulhodzed by fhe ownor ol fhls property fo perlorm fhe <br />�vark tor which aOP��ca�ion is made and I tomply wifh fNe Stafe Confracfors Law 18.27 RCW and <br />296.200 WAC. <br />nc•wsEoaameoor. <br />FE[ <br />� 5fl �°� J <br />PERM]Tk <br />E l5b'�' 1� I <br />