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ELECTRICAL PERMIT APPLIC�ITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRGET. EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — v,nw� everettwa org <br />t�63 <br />� lk'� 9/'. S� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />�i��ZI <br />�dai� Address <br />t:iad Address <br />I� <br />�K. t <br />Gry <br />C,ty <br />( <br />StateiLp <br />Sla!e�Z�p <br />Phone <br />Phone <br />�v��� � r�� T�,� �, } 9��� ,��� r�.� ;f�, «��,�� �z�v <br />E!eclr�calContraclor lda�lAddress C�ly State'Z�p s'��_CS� _r,Ppot]e <br />- 3 C.lTJ <br />ZS� `�� <br />�z5 �c� 9;�/c� -- � <br />State Licerse Number CoNracl Price o( Work <br />�I P�oposed Use of �uilding <br />Square Footage pf residentia� nee� conslruUion, remodel or addition) <br />Number of devices (If low voltage) <br />L'escription ot'Nork lo Bc Done- �Tr'�i ('/7 �{,j.���{' <br />Coniact Person (Plan Rzview) <br />� �F[E <br />� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �I //�O O� <br />I hereby ce�irly that ! have �ead and examined Ihis applicafion and kno�v the sarne !o be Irue and L___ /_ .___ _.__ __ <br />� correcL All provisions o! lav:s and ordinances governing this (ype ol work will be cornpleted --- --�-- <br />! �vhethei spec�ficrl herein o� nof. The granfing o/ a pem�it does not presume to give aufhonty to PERMIT� /�,� <br />'I �nolate or' cancel lhe provisions ol any ofher stale or local law reg�lating consWchon or fhe r �,11 VJ <br />� per/omiance ol ConsWclion That 1 am authonzed by Uie o�vnero(Ihis property lo perlonn Ihe t I(�� O�`_ <br />v:ork lor�vhich applicafion is rnade and 1 compty rnlh (he Sfa(e Contnctors Law 7827 RCW and l_ _ _ <br />� 296.200 WAC. <br />Z � J� � <br />� ..,.... ,... <br />