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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVEnETT PERMIT SERVICES <br />3200 CEDAR STREET, EVGRETT, NlA 98201 <br />4?_5-257-8810 - FAX 425-257-8857 — wvw✓.everettwa org <br />Ci3�o - i yz <br />1 � `"�7`"� 3 <br />9�0 5�2 si s.� <br />PROJECT ADORESS <br />D 5 Z ST <br />Owner <br />�, <br />Tenant <br />eJectrica�/��tra� r <br />�rfail ACtlress <br />�� <br />tdail Addrcss <br />�Aail Address <br />Stale License Number <br />��a?-Y� � .��5lC�-C-�,rCIL <br />Proposed Use of Building <br />Square Foolage (:f residenlial new construclion, remodel or addition) <br />Number o( devices (If lotiv voltage) <br />Description o( Work to Be Dane: <br />��-CG !� � �/ , <br />��}� f� ��l �x�s <br />City <br />�� <br />�,;Y <br />City <br />S;ate�Z�p <br />i� <br />State2ip <br />Slate2ip <br />yz� zsz ��� <br />ZG 3 <br />Phone <br />�Cl �7d Z � <br />Phone <br />Phone <br />Contrect Price of Work <br />ContaclPerson (Plan Review) <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �`�"J �� <br />I hereby certily (Ira( I have read and examin�;l lhis application and kno�v the same to be tn�e and <br />co�rect All provisions ollatt�s anJ ortlinances goveming this type of wo�k ivill 6e cornpleted <br />whether specified heiein ornot (lio gran(ing ol a pemiif dor,s nof presume to grie au(honty (o PERMITn <br />violafe orcancel the provisions o/any o(hersta(e or local law reyulafiny constn�cfion or Ihe <br />pedomiance o/constniction. That 1 am authonzed by the o�vnerol this propeRy (o peAom� the E��� O— r � <br />�vo�k !or tihich application is made and I cornply ivitlr the State Contr<vcfors La�v 12.27 RCW and <br />pewseo v ar � <br />