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El.ECTRICAL 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 <br />2�1�t� ��" Sk <br />PROJECT ADDRESS <br />��-,e�- Co � <br />Own�r <br />Tenant <br />� <br />o� �� � " <br />Mail Address <br />Mail Address <br />,�� �(��� <br />Eleclrical Conlraclor Mail nddress <br />T�11�ov �.5 �752 �C� <br />Slate License Number (requued) <br />Proposed Use of Building <br />�e��H- <br />City <br />Cily <br />.� ��;� < <br />City <br />Square Foolage (!f residenlial new conslruclion, remndel or addihon) <br />Number ot devices (I( low vollage) <br />Description of Work Io Be Done: �ud d� e <br />3�a3-�S <br />E l5(%3 `J �-b� <br />� �-7rS-�85� � <br />StatelZip Phone <br />Stale2ip Phone <br />., �,��- �'�z�� yt� z3y-o��� <br />State/Zip Phonr. <br />����� <br />City of Everett �usiness License NumGar (required) <br />�j/ �M •1 <br />r GW <br />Coniract Price of Work <br />1�tK1�u�k- NZS 923� � ivc� <br />Contacl PersonlContad NumbedEmail <br />c i erti <br />CITY OF EVERETi LOCAL SALES TAX CODE IS 3105 <br />I hc�eby ce�fi(y (haf 1 havc �ead and examined fhis application and know fhe same fo be !nm and <br />conecf. All provisions o/laws and ordinances 9oveminr� ti�is lype ol work will be completed <br />whclher speci(ed herein or noL Thc gianling aI a permi( docs nol presumc lo c�ive au(I�onty fo <br />violate or cancr,l !he provisions of any other stafe or local law reyulafing constn�r,fion or fhe <br />peAomiance ol consl�ucfinn. Thal I am authnnzed by the nwner ol fhis propeify lo pe�lonn fhe <br />work !or which app/icalion is rnade and 1 cornply wifh Ihc Statc Confractors Law 1827 RCW and <br />296.200 WAC. <br />�,rvrsCOorA6nnra __— —.- ---- -- ---- —. <br />C . � <br />FEE <br />���' <br />P[RMCT7t <br />E (503 �f Zg <br />