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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEOAR STREET, EVFRETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettv+a.org <br />� ' U��T 9�Z � <br />l��y 5/ ����'w � ° <br />PROJECT ADDRESS <br />3 � zz—i3 <br />C �3o�—�S > <br />ti1�rT �E�� <br />Owner �dailAatlress Ciry State/Zip Phone <br />Tenant <br />Eleclrical Contractor <br />�'�trlrs,s�t qa2 v� <br />Slate License Number <br />Mad Address <br />Idad Address <br />Proposed Use of Building <br />Z�o 5� {� <br />Square Footage (If residPntial new construcfion, remodel or additicn) <br />Nmnber of devices Qf low vollage) <br />City <br />City <br />Slate/Z�p <br />Slate/Dp <br />�j bG:00 <br />Coniract Price of Work <br />Contact Person (�'lan �'=view) <br />Phone <br />�9 3vo2 <br />Phone <br />Descriplion o( Work to He Done: /ikJ�� ���� C=�/� �'�� 0�5 f 5w�" - S <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceRily thaf I have read and examined (his applicafion and kno�vlhe same fo be (rue and <br />correcf. All provisions ollaws and ordinances goveming this fype ol work will be completed <br />whefher specifred hemin or not The granfing o/ a pemiit does nof pmsume fo give autho�ity fo <br />violate or cancel the provisions ol any other sta(e or local !aw regulating construction or the <br />pedomiance nl cons(ruction. Thaf I am authonzed by the owner ol this pioperty fo peAann fhe <br />work lor which application is made and 1 cornply wiU� Ihe Stafe Con(ractors Law 18.27 RCW and <br />296.200 WAC. , �. / <br />3/�/3 <br />rcviseu v�au <br />FE[ <br />�.O � � <br />PERMIT� <br />E�303- 153 <br />