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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 7_ a 3�. �3 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />EI�i7—ID—� <br />�' I f c � `_-, � � (=— <br />�� � �� 1 � <br />i PROJECT ADDRESS <br />�;�11,`.. � CIIt �, li(�� �`.+„ .i -�,( �,%r`� }1 <br />� -- — <br />�, Owner Ma�lAddress City <br />Tenant <br />i�C=(cz_tr,'( <br />. ElecCical Contractor <br />Mail Address <br />7� ' c <br />Mail Atldress <br />C Y�� Ll L L �i<`� L`� <br />� State License Number <br />1' <br />Proposed Use of fiuildiny <br />Square foolage (If residen�ial nev construction, remodel or addilion) <br />Number ul devices Qf low vollage) <br />City <br />Description ol Work to Oe Done: 7� f �•� i�Cl � u: � C ��� l�"' � <br />��,� <br />9lale/Zip <br />Stete�Zip <br />•11�; -,�'t i �`i3r <br />Phone <br />Phone <br />�;1� '�'y1�(.r �r(r �3 /1/!- <br />Slate2ip Phone <br />C. <br />; �(�.�, -- <br />Contract Price of Work <br />Cunlacl Person (Plan Review; <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � f:� C�U <br />I herehy certdy Iha! I have �ead m�d cx.�rnir�ed fhis epp6cahorr nnd hnurv flm snnro to De (rue and <br />rormct. 1111 provisions ollaws and o�d�nmrces gownring f/�i� type ol �vork �vill be cumplefed <br />i:hefhr,r specilied hmcin or not The gmnting ol n permit dors not prosumo lo give aufhonty fo PERMI ,+t 'i <br />r�olefe or cnncel flre provisions o/ any oiher slnle or locol la�v iegulnting constn�cfiorr or fhe / l � <br />peAonnmt�o ol conslnic(ion Thnf I nm ��u�honzed by fhe owner ol this praperty fo Perlortn the E I'� �-{ — I�J I <br />r:o�k lor which a�zv6cafion is made ar�l I compty � h the Sfnfe Confr�ctors Lnw 18.27 RCW nnd i <br />29G 20 C. I � � <br />�_1:�` /I'%—�/-� �� {�� �I2ci3 I <br />�„ <br />