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• ! <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 '[ <br /> 425-257-6810 - FAX 425-257-8857 -www.everettwa.org `'�".���s <br /> ��5���`�� <br /> IioOZ H��WI�r'T �I� . <br /> PROJECT ADDRESS <br /> Sk�t-dah 1 <br /> Owner MailAddress City StalelZip Phone <br /> TBnanl Mail Adtlress Cily State/Zip Phone <br /> �j-fCR-I.IYJC� TGl-�GOY�I rCiOZ l��N ST sw �II����ER�'rT', w� �1�GZ04- �4t�)3b�- % <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 5'�KtTL��4 G`1 D5 0410°I <br /> State License Number(required) City o(Everetl Business License Number(required) <br /> c��� ��� U�Pc,rz.A+� CRoc��=ToPL <br /> Proposed Use of Building � Coniract Price of Work <br /> (aAv�N SwfWNE/3bi-�57t,'qav�.T,Qs I� <br /> Square Footage Qt residential new conslructioq remodel or adddion) Contact PersoNContac NumbedEmail }� c�,ry� <br /> 3 <br /> Number o(devices(I(low voltage) <br /> Description of Work lo De Done: ��lJ/�C..0 CX ISTI N(�� �0��( G (�l�l.,�,s Vv 1 1 F} �`� <br /> {}yg���=��sE� Y�►1ir.��iti� . M/1in,��NL lnn� r�E "r_ewl�Naz�.p> A�T <br /> 3� ���VL�OZ'� 2n�7c0 UNITS <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 � S UC� <br /> 1 hereby ceAily fhaf I have read and examined fhis applica(ion anA know(he same fo be fn�e and <br /> correcf. All provisions ollavis and ordinances goveming U�is type ol worN will be completed <br /> whefhcr speci/ied hwem or noL Thc grenling ol a pemrd does nof presumc fo give aulhorrty fo PERMIT# <br /> violate or cancel fhr,provisions o!any olher sfate or local law rcgulating consfn�cfion or tbe <br /> pedom�ance ol construcfion. 7ha11 am authorized by fhe owner o/this property fo perlonn fhe E g I 5 o y� - �� 3 <br /> worN lor wluch applicafion is made and 1 r.ompty wifh Ihe Stafe Confrar.(ors l.aw 18.7.7 RCW and <br /> 296.200 WlIC. <br /> 411��1s <br /> i9na1 � . �ale <br /> nevrseoonrovmin <br />