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I <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERM17 SERVICES <br />32C0 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — vrw�v everetiwa.org <br />� (.� �So2 -D �-ib <br />� ��13 �+` � r �.J a -a3-i5 <br />i <br />� PROJECTADDRESS <br />I ��, �,�,c, �-�13 �` Dr �J ��erv� W(i °l`�5 �(.Z�3� �f��i��l <br />Ovrnef �Aa!IAddress Gty Stale!Zir Pr,one <br />I <br />Tenant �dailAddress C!ty StatelZip Phene <br />I l�� <br />, Electrical Con�r2 <br />� <br />SI J� 3�0� <br />'dail Address <br />� i,1� 11-1 tJ1� 7� l� b�- <br />'. Stale License Number (required) <br />� Proposed Use of Building <br />Square Foolage Qf residential nev� construction, remodel or addition) <br />c�ry <br />SlatciZip <br />Phene <br />C>`��� ! � <br />Gty of Everett Business License Number (required) <br />Contracl Price c('A'ark <br />Conlact PersonlContact NumbedEmail <br />1 <br />Number o( devices Qf low vollace) <br />Desciiption of Work to Be Done: �yti�,/11��_I �'��"__ �..� ^- (�R.-( I <br />U <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 l� U� <br />1 hereby ceildy Ihat 1 have mad and examined this applicalion and knoa the same fo br. fnie and <br />correcL Flll piovisions o//aws and ordinances �avemin9 fhis type ol�vork will6e complefed <br />�:�hc,'her specified hwein ornoL The 9��nling of a pemiit does not presume fo give authonry (c PER141T�P <br />violafe or cancel Ihe provisions ol any olher sta(e or loca! law regulafing cons(rucfion or (he <br />perinnnance ol consWcfion That I am aufhorized by fhe o��,��er o(fhis property to peAnmi fhe E� ���� -Q `f Q <br />roAc /or which applica(ian is made and! comply ��if�i the Stafe Confnctors Lmv 18 27 RCW and <br />296.200 W�7C. . /1 �% / <br />Z�/ % <br />R_:)sED Oar ;; 9�c <br />