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_� _---� � �������� ° ���.� -- <br />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 />� l� �l� �/I� 5�r' �-t�c� <br />PROJECT ADDRESS <br />5_ Z7 -�3 <br />C-i��3-1�3 <br />�� g� <br />Owne� Mail Ad�.'ress City Slate/Zip Phone <br />Tenant <br />ldail Atldress City <br />%d'�Y C.w+K�% �O <br />Contractor tdaJAddress <br />�'1�r5 �� yoz�� <br />State License Number <br />Proposed Use of Building <br />(If residenlial new consiruclion, remodel or addition) <br />Number ol devices Qf low vollage) <br />City <br />State/Zip <br />Phone <br />3�y3� 2. <br />StatelZiD Phone <br />Coniracl Price of Work <br />Ccntact Person (Plan Revie�v) <br />Description of Work to 6e Donc: %SrLLcCY%�� ��%f�L f�` ��"'���� <br />CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br />I heieby certily (hat f have read and examined this applicalion and know the same l0 6e true and <br />coirec(. �ll pruvisions olla�vs and ordinances goveming fhis type ol work will be cornplefed <br />whether specilied hemin ornoL The gianting ol a permit does not presume lo give aufhonty to <br />violafe or cancel fhe provisions ol any ofher s(afe or local law regufafiny consWction or fhe <br />peAomiance o( constniclion. Thaf I am aufho�ized by lhe owner ol Ihis properiy (o pedorm tlre <br />wor� Ior which applrca(ion is made and 1 comply with fhe Slate Contrac�ors Law 78.27 RCW and <br />AewsFo.vlai� <br />FEE <br />PERMITtt <br />E ���� - Sd <br />