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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C[DAR STREET, EV[RETT, WA 98201 <br />425•257•8810 - FAX 425-257-8857 - www everettwa org � n r 7_�� <br />�5 f-�, ,st j E I, <br />�� . <br />PROJECT ADDRESS <br />� �}. /. .�� rr. � I 5L <br />,Jcnl� V"I�:7- yc�--- �y��� <br />Owncr " � � Ma�IPod•ess ----- <br />ci yin- � 3 <br />('y 7•) c+n7 �bo �3 <br />Ev r i� /r ,. 'G � <br />�`/ _ ��` - -- <br />C ty StatClZip Pnonc <br />_.�L�------ --- -- —. .. . Pnonc I <br />1 enant Ma�i AAdress Gry Sla'crZ D <br />� <br />' h ' <br />� 1y25 �sr~Sr�E �vc.,p t��. 9S'I�.� (c/25�`-fo7-Sis�?z <br />I�OG+tL Uv�(.2 __ —'--' <br />�,i Stateil.�p c>hone <br />Fleclncal Contrdclor 1.1a i Address Y , <br />� <br />Slate License Number (reqwred) Gly ol Everett Ousmess license Nimiber (reQuued) i <br />Pruposed Use ot Owld�ny Contract Pnce of'Nork <br />� Squarc Footagc pf residential new cons � id�on, remndcl or add�;ion) Conlad PcrsoriContact NumberlErnad I <br />�, Number o1 devites (II low volla9e) <br />.r..,r L u � YD 1 t� I� � % e o� t i <br />Descnpt�on of Work to f3e Done /��� � ��--- �-� `- � —� -------- — —' -- --- <br />F[E — — -- — — <br />I�� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 GJ�oO <br />I hi•roby certrly fhaf 1 have read and erammed t/ns applicafmn anJ Frio�v fhe sarne fn be fn�e nnd ---_ --- -- <br />� cormcf. All pinvisions ollaws and ordmances gnveminy fbis type of n�ork wrll be completeJ - <br />� ���hefhcr sper.dicd hcrcirr o� nnf Ihe ��anGn9 0l a pemuf does no( prosumr fo 9rve aufhnnty fn PFRMIT4 <br />�� violafe or cancN fhe provrs�ons o! any olher sla(e or local law mgulaGrg consfrucfron or fhe E I�f ( D l`� J <br />pe�forrnance o! consln�c6on Tha(1 arn aufhonzr.d by fhn owner al fhrs pmperty fo pedorrn fhe <br />work lor whrch app6cafion is made and 1 comply wdh thc Sfatc Contracfors Law iB 27 RCW and __ _-- <br />296 ?00 WAC <br />; <br />L (c <br />���—' — � -�— ---- lD ? 7 -- <br />--. Siyna��e Date <br />� ;:t.���dno5t.5:.��� _ — . __ _ _ - _ _ _ .. _ ._ ... _ ' <br />