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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 everettwa.org <br />123 G,c14lr �L S. E, Et/OZeTi <br />PROJECT ADDRESS <br />Crr7 e6' o kxE -s <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address City <br />Stale/Zip <br />T _ J.zS—Zone <br />6r/Z rQ N rf- <br />Fzza- Po 0ox ,2 `3C) Eve7I I7r <br />O J14- <br />L <br />9 S 7 r 3 <br />ElectricelContractor <br />Mail Address CRY <br />State/Zip <br />Phone <br />Ljl�cil7rNe <br />Slate License umber <br />6�74/1-4&F77- <br />Proposed Use of Building <br />yCo <br />Square Footage (if residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />zinc r <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I hereby candy that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work v I be completed <br />whether specified heroin or not. The granting of a permit does riot presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />perfomranco of construction. That I am authorized by file owner of this property to perform the <br />work for which application is made and I comply will) tho State Contractors Lew 18.27 RCW and <br />296.200 WAC. 11 ) <br />c JO -10 -15 <br />FEE <br />rPERMIT# <br />E �3co—ot5 <br />V -k 7%7S <br />rFVISED rMl3 <br />