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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SE4VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />G` S `3`� r � S�- <br />PROJECT ADDRESS <br />Owner �datl Adtlress <br />Tenant <br />Mail Address <br />E Ic�-4��� ��L <br />Eledrical Contraclor Maii Address <br />C c,�� Sse qa3 � � <br />Slale License Number (required) <br />S� n� � '1 qv-� , � � <br />Proposed Use o( Building <br />Square Footage (If residential new construclion, remodel or addition) <br />Number of devices pl low val�age) <br />Gty <br />Ciry <br />/"I ul�, �; <br />City <br />C-)��z-��'3 <br />1a-i7-i�F <br />SlalelZip Phona <br />Slate/Zip Phone <br />t��- y� �B , <br />StatelZip Phone <br />_ (1 S�`'�� `� � <br />City o( Everett Business License Number (required) <br />COG � `� <br />Conirac! Price of Work <br />CoMacl PersoNCoNac! NumbedEmail <br />Description of Work lo Be Done: _`l'tvU �.� �`�e \ uFn�+nc�Q � ��r�� '— �� ��5�' _ <br />C� �Cc S �.� �'r145 � //�?c:�� — <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fhat I have �e�d and examined this application and knmv fhe same (o Ge true and <br />corroct All provisrons ollaws and ordrnances goveming this type ol worN �vill be compleled <br />whefhcrspecified herein ornoL The gran(ing o/a permif o'oes not presume (o give authonty to <br />violafe or cance/ fhe provisions ol any ofherslate orlocal lar� iegidahng constroction or fhe <br />peAennance olconstructi hat I am aulhonzed Gylhe o�vnerol(his property (o perlonn Ihe <br />work (or which application�i.� r�ade and 1 compl�� wifh fhe Stale Confroclors Law 18.27 RCW and <br />PEVISE00806201i <br />�_ <br />f-EE <br />7�� <br />PERh1IT„" <br />EI�(z- lz-s <br />