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ELECTRICAL PERMlT APPLICATION <br />CITY OF EV�RETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX �'.25-257-8857 — vnvw.everettwa.org <br />; �L/ ��% ` � � r��,b� -� G.— <br />PROJECTADDRESS <br />� <br />A � .� �,,, c�, /��S> �,3 `��,�V � <br />Owner <br />Tenanl <br />Eleclrical Contractor <br />Mail Audress <br />Mail Atldress <br />Mail Address <br />��..co.��nl���U g A � <br />Stale License Number <br />Pioposed Use of Building <br />City <br />City <br />�i #�C7 ,_ . <br />Square Footage (If residenlial new conslruclion, remodel or addition) <br />Number o( devices (If low voltage) <br />Gescription of Work lo Be Done: <br />CITY OF EVERETT LOCAL SAL[S TAX CODE IS 3105 <br />City <br />State!Zip <br />StatelZip <br />SlatelZip <br />�-��i -/3 <br />� 1�3D6�fI� <br />cr° <br />S GrC� . <br />Coniracl Price of Work <br />.�c�-y�c'"9d b <br />Phone <br />Phone <br />c�3s`73s� <br />Phone <br />Contact Person (Plan Review) <br />1 hereby ce�ti/y that I he�, s �ead : nd examined this application and know the same (o be tnie and <br />canecL All provisions of laws m�d orr/inances goveming this lype ol wodc �vill be completed <br />�•:hether specilied herein ornot The gran(ing oI a pemiif does nol presume fo give authonty to <br />��� violate or cancel fhe provisions o( any other slate orlocal laiv rogulafing consfn�ction or the <br />peifor.nance o/consln�ction. Thaf I am aulhunzed by the owner ol this prope�ty to peAorm Pne <br />�;;odc /or �vliich apAlication is made and I co�nply �vith fha State Confracfors Law 18.27 RCW and <br />� 29&200yYAC. n <br />fl <br />����.s�������_ <br />�_-- <br />� —i9—i� <br />F[E <br />r� <br />�; �� <br />PERMIT# <br />i i �. <br />EI�G� -I� 6 <br />