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• <br />ELECTRI�AL PERIIliIT APF'LIGATiON <br />Z �i3 <br />CTADDRESS <br />CITY OF EVERETT' PERMIT SERVICES <br />3200 CEDAR STREL=T, EVERETT, WA 98201 <br />425-257-8f110 - FAX 425-257-8857 — wvn�v.everettwa.org <br />/a �i3-i� <br />�.� J �- ��iuii-�i <br />? F l�c�'� 7T � , <br />' %ZZZ <br />Owner Mail Adtlress City SlalelZip Phone <br />G/��I/'�.Dl�/��/ �D/���` <br />Tenant Idad Atldress Ciry Slate2�p , Phone <br />Dwn�r <br />Elec�rical Contractor <br />Stale License Number (required) <br />�Aail Adtlress <br />��iP <br />Proposed Use o( Building <br />�DD 5��, F�% <br />Square Footzge Qf residendal new conslruction, remodcl or addition) <br />iJumber of devices (If low volla9e) <br />Ciiy <br />Slate/7ip Phonc <br />City of Everett Business License Number (required) <br />Contract P: ice of Wor <br />,Po�✓ �✓���-' i'Z.�S�oBC.� G c; <br />,PoNN�E'liysl, n/�G <br />Contact PersonfConlact Number/Email <br />Desr.rip�ion of Work lo fic Donc� �f7%/���(J � `�'v�7 � ��je �(1/C C✓ /�� <br />�/��G � �9� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hrreby r.erlr(y Ihaf I frave �ead and ex� mined fhis applicalion and know Ihr, same to be frue and <br />corred. All provisions ol laws and oidinancr.s governing thi, lype o/ work wrll be complefed <br />r�hnlhr.r speci(�d hercin or noL The granhng o� a perrnd docs nr,! presume fo givr. aulhority !o <br />violafe or cancel thr- provisions oI any ofher sla(e or local law regula(iny construclion or the <br />peAormance oI consUuction. Tha( I am au(horired by fhe ownr.r ol fhis property to perlorm fhe <br />�•�ork%r vhich app:icalion is made and I cornply wilh Ih,e S(ale Confraclors Law 18.?7 RCW and <br />2J6.200 ' <br />- �/-_�� <br />$i� lu . Uaic <br />,. �narnn:'u✓�on <br />f[f <br />� O� <br />PFRMII7; <br />E(�(�I�DIg <br />