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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org C_? „_� <br />J ow <br />�y �'JOS-lb�o <br />?ll ll��l, St S�" <br />PROJECTADDRESS <br />�� �l �n l�i IiC� ���_ <br />Owner Matl �ddress <br />S /�eE (��1<e �1za .2 <br />Tenant Mail Address <br />City <br />la t� S f 5 r, <br />City <br />�C�i'ec �lac{��rc,� oZ/�/,�/ N G•�� <br />Eledrical Contraclor Ma�l AdJress <br />St.�,,T�F S�i 9.� k P <br />State License Number <br />L r.. <br />� t� �� , f � s�� � <br />Pro os Use of Building <br />Square Footaye Qf residential new construct�on, remodel or addition) <br />Nmnber o1 devices (II low voltage) <br />I Description ol Work to Be Done: <br />City <br />d• <br />StatNZ�p <br />StelelZ�p <br />StateQip <br />�� �G 7L L <br />Contract Prico of VVork <br />Contact Person (Plan Review) <br />/r <br />Phone <br />Phone <br />Phone <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CUDE IS 3105 `-]� '7 (",, .� <br />1 <br />I herc6y curhly thaf ! hare ierid and e�amined fhis npplicafion and Fno�v fho same fo be tn�a ��nd — <br />conrcf. AH prvvisiorrs o/l,nvs rind or�iinances governing B�i � type ol wo�k �vill be complefed <br />�vAefOerspecilied Irerein ornoC The granfin� ol n pennif does nof presumu fo give nuthonty fo PERMCEN <br />vio/rite or cancel Ihe provisions o/ nny ofherstale or local law rogulnfing consfn�ction or fho _ <br />pedonnance ol consfn�r.tion. That 1 am authonzed Gy fhe o�vner o/this prope�ty to pedomi tho E �'��[ �� -�� �, � <br />�vo�k lor �rhich applic�fion is rnnde and I cornply wi(h Ihe State Contracfors Le�v 78.27 ftCW and _ <br />296200 bNAC. <br />�/ <br />