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Ir:dl :q:'.- PROvI:er•i _ •' PAGE 02/02 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET EVERET ' WA 98201 <br />425.257-8810 • FAX 425.257-8857 —wrww everettwa oic <br />I I W e-1011�1C:�v SUV <br />PROJECT ADDRESS <br />4 z5.318 azV;, <br />CC-Q N- <br />Owner Man Address C'ty <br />SrateRp Pno e <br />Tarrant �--'Aav Addmss Cuy <br />Slalefzv phone <br />•7�3 • c�•31 •'1"1Si� <br />2�—'1_ic1eT/_` -�—+� ----r_ ktater2ip Phone <br />Electrical Contractor Man Address Cr4 <br />i7f�n� 1T17'T' r llt�h/'2. <br />State License Number <br />Propor; Use o in9 _ <br />Square rootage (it residential new construction, remodel at addition) <br />Contract Price of Wore <br />Con ct Per'On (Plan Review) <br />Number of devices (If low voltage) .-s /''� 1A� <br />Description of Work to Be Done !N— � —F JZ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9106 <br />I hereby certify that I hove read and examarod Ibis application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified heroin or not The granting of a permit does not presume to 9" authority to <br />violate or cancel the provisions of any other state or local law regulnring consfrucflun nr the <br />performance of construction That I am authorized by the nwnor of this property to perform the <br />work for which application is made and I comply with the State Contractors Law t6 27 RCW and <br />296200 WAC <br />/�a�..n/It•1 / �� 1 • I•�� <br />REV6EVY lj <br />FFE <br />�0 <br />PERMITO <br />E 1307-_ COZ <br />