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� <br /> ELECTRICA�.. PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-6857 -www.everettwa.org �I `,a� ,��y <br /> � �� <br /> ��1� ��� �f <br /> PROJECTADDRESS <br /> Y�t a, ,���? 5{���'� �ol°�' 2v� S�- �✓e%� �J�f�- �l� 7�-2sy zy23 <br /> Owner MailAddress City StatelZip Phone <br /> Tenanl MailAtldress City Slate2ip Phone <br /> �w�,L s �c���c 7�l �y�/ ��✓c✓ �.�� �✓�-q'�z-�2 <br /> Eledrical Conlractor P�1ail Address Ciry State/Zip /J���j^Phone <br /> 7 ioci 9gf�2 <br /> �'l�K �'za3�x� 0.�3�o�' <br /> State License Number(required) City of Everett 8usiness License Number(required) <br /> ��. °� <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage (I(residenlial new conslruclion, remodel or addition) Contacl Person/Contact NumbedEmail <br /> Number of devices(I(low voltage) <br /> / � r J �/''�� �',,,,,,,,�� <br /> Description of Work to Be Done: f"f�d l.U� ��"(J✓ 15��a �� __�� <br /> , FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � �/� O� <br /> v <br /> 1 hereby cedi/y(hat I have read and examined fhis application and know the same to be Inre and <br /> correct. All p�ovisions ollaws and ordinances goveming Ihis type o(ivork will be complefed <br /> whefher specified hemin or noL The granling of a permit does not p�esume to give au(honty to PERMITtI <br /> vio/ate or cancel fhe provisions ol any ofher st�te or local law iegulating consWcfion or the � r , / <br /> peAormance ol conslrucfion. 7hat I am authonzed by the owner oI Ihis prope�iy to pedo�n the (N D L.( � � 7 �n <br /> work/or�vhich application is made and I comply with the Sta(e Conlracto�s Law 18.27 RCW and � � 1`� <br /> 296.200 WAC. <br /> ���� �' -2�`�9'��_ <br /> �gnaW re Dale <br /> newseooamvroia <br />