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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT� PERMIT SERVICES <br />3200 CEUAR STREET, EVERETT, N/A 98201 <br />425-257-8810 - FAX 425-257-8857 — �w�nv.everettvra org <br />� / ZC�/L J5'� i>� N`-- <br />� PROJECT ADDRESS <br />, %O �.i5�i�-. IZ e y�/ e� 2� (� a-. �i/'�,--c �Jr�-. \\ !'�v� 1- � � � �� <br />'. Oraner t.1aJ Address Gty SlatelZip Phonc <br />I <br />lenant <br />fdail Address <br />City <br />Slate/7ip <br />Phone <br />� <br />� I ��o�,Tea I=��TA i � L�L� G�/3z 97 s,—. NF__Ir�'yt�sJ��-+� r..1�4. 9kZ�o <br />�i Electrical CoNractor !.7a�l�ddress G;y St.te�Z�p 360--6Si -��� <br />I (A��S�c.��9��Ki <br />Staie License Nurnber <br />, �$ i �^ ) �-� �4w, � L y /�h v.� r <br />' Proposed Use of 9uilding <br />� Zd'' % S <br />; 5yuare Footage Qf resiJential new consiruction, remodel or additio <br />I <br />:Vumber of devices Qf low vol�age) <br />� <br />�Da <br />Contract Prlce ol Work <br />�e_�-2��.ti - �/z5'-�i5-�v <br />Contacl Person �Plan Revie�v) <br />I)escriplion of Work to [3e Done� �fi%,7 ��.�c._ Co•-..STPwc.TJ U,q _ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceriily thaf I have read and examined fhis app6cation and kno�v fhe same !o be (�ue and <br />cormcL All provisions ollaws and ordinances governing this type o/ work r;ill be cornplelcJ <br />�:hether specilied herein ornoL The g�an(ing ol a pennrt docs nof presu,7ic to give auUio�ity fo <br />v;olafe or cancel (he provisions oI an� other stale or local la�v regulating consfn�ction or Uie <br />p�rfomiance nlcons�n�clion. Thaf 1 am authonzed by fhe o�vnerollhis prope�ty to peAwm the <br />:t�ork Ior �vhich apphcalion is made and 1 comply with the Sta(e Contrac(ors La�v 18.27 RCN1and <br />296 200 WAC. <br />z — ��j'/ <br />,; ;,,_�.a ,:.-,� <br />FEE I <br />�U-�� <br />L_ -- <br />�— � <br />PFRt�1[T.r � <br />E i�foa-<<a I <br />