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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857—www.everettwa.org ✓D� `� �� <br />Inc), I L SIC <br />PROJECT ADDRESS <br />6recJ NH2ur(j lb,101 �� S� E.yeYc I rn �3�ot <br />Owner U —S Mail Address City State0p Phone <br />Tenant Mail Address City StalerZip Phone <br />StaliS 1 Ila,`1 `13, S� SE SAJ- k� ;'S'L. lti-F, gti�l9n Has 34N ins, <br />Electrical Contractor Mail Address City State/Zip Phone <br />3coD.: <br />Solist;I d� <br />State License Number Contract Price of Work <br />k DUSC. <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />�4.11Y< nhci i1�3�'q\1 GY�c. t1Ccv C:c�'�KfIG� Ct7 Ay pStrVlce <br />Ov,E Y,ew ack A•p (•e <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 -71 <br />1 hereby certify that I have, -,ad and examined this application and know the same to be true and I <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br />violate or cancel the provisions of any other state or local law regulating construction or the I �Q performance of construction. That I am authorized by the owner of this property to per the <br />work for which application is made and I comply wilt) the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />(� t, )3 <br />Sign 1 re Dat <br />RevrscD aaau <br />