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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVER6TT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8657 —v✓rvw.evereltwa.org <br /> . <br /> / a3o � � = A�� s� <br /> PROJECT ADDRESS <br /> 6a�G r i' /�� m GS <br /> Owner hladAddress Cd� StatelZip Fhone <br /> Tenant F.tailAddress City State/Zip Phone <br /> Nor�hcrn �� '�f �`�t�� lnc- <br /> Elecirical CoNractcr h1a�lAddress C�P/ State2:p Phcne <br /> /i/�� T�-/.� �� c��y ��7/' U 3 .z�'� y <br /> , S�ate License Number (raquired) City of EvereU Business license Number(required) I <br /> iSFR -- -- ----- -- <br /> Proposed Use cf Guilding Ceniract Price o('Alork I <br /> �573 <br /> Square Foola�e Q(rzsidential neei construction, remodel or addition) Cen!act Person/Contact NumberiEmail <br /> �Vumber of Cevices (li lotiv voltage) <br /> Descriplion o(Work to f3e Done: Li///'L� ,.7 N L�'J S 4_ J��T ,?/G� �"' /'l o rh g. _ <br /> ---7 <br /> — - - — I <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 + v� O �O <br /> I <br /> !hereby ceRily lhat/have read and exarnined fhis applicafron and kno�•�Ihe same to te lrue and <br /> conecL �II piovisions o(/aws and oNrcances goveming(his type ol�t•ork�vill be complefed — <br /> �ti-hefher speci�ed hemin orncl. The g;anting c(a nem�it does notpresume(o give aufhonty(o p[k��1IT# <br /> violale orc�ncel!he Frovisions olany ofher sfa(e orlocallaiv regulating conslruc(ion or fhe ��� O � r�� I <br /> performance o/construc(ion. Tha(1 am au(ho�ized 6y fhe o�•merot fhis property fu pedomt fhe ,� "' V L <br /> �vork for which application is made and 1 compty�vith fhe Sfafe Confractors Laiv 18.2:RCW and <br /> 296.200 WAC. <br /> �.�ll�.�/ .3/ �//�.� <br /> Sigralure � <br />