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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-BB57 — www.everettwa.org <br />7-/D--/� <br />,� o o SE �.K/-� /�, � � 1 W a <br />PROJECT ADDRESS <br />�J�JfhSoh )%YD�t✓�fs <br />� � uo � �O� <br />Owner Mail Address City State2ip <br />,�Gc vh � SD 0 S E�'Gt"C � �'h a(/ �1 t. c.� �1/-(�i-t � <br />Tenant <br />Mail Address <br />C�•-� l`+��r' S���j � S ` <br />Electrical Coniractor Mail Address � <br />r3eary�lJ�o 8�'�.3 <br />State License Number <br />Proposed Use of Bui�ding <br />City <br />S�w,S ?`fo� <br />Ciry <br />Square Foolage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Descriptian of Work to Be Done: <br />State/Zip <br />Phone <br />Phone <br />�a(tSoh �u� EY'crrtt g�'7-a3 <br />State2ip <br />� �� <br />CoNract Price o( Work <br />(�Oh r� Q (�YtG h. <br />Contact Perscr. (Plan Review) <br />�-,ovZ C�J o�te ��C�'Sfi��'c� <br />�/lu w„'h a f�e� �,v� c I s r S h <br />Phane <br />FEE <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 /�O �� <br />1 he2by certily fhaf 1 have read and examined Ihis application and lmow the same to be fnie and ��> <br />correct Nl provisions ollows end ortiinences goveming this type ol work wi%t be c.nmplefed <br />whelher spe�ed herein ornot The granNng ol a pertnit doas rtotpresur.�e to give aufhority to PERMIT# <br />violafe orcancel fhe provisions of any ofherstafe orfocallaw regulafing consrruc6on or fho r /�� D�� <br />performancs o/consWcfion. Thet 1 em authorized by the ownar o/fhis properly fo perform Me C � <br />worf� /or which application is mede and ! comply with the State Confrectors Law 18.27 RCW and <br />246.200 WAC. „ <br />• ��r� <br />FEVISE032643 <br />