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ELECTR�CAL PERMIT APPLIGATI4N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi",WA 98201 <br /> 42b-257-88'!0 - FAX 425-257-8857—www,everettwa.org <br /> 26 l o �alt��e s���Fe b Everet� �v,� 982a8 <br /> pROJECT ADDRESS <br /> Owner Maii Address City State/Zip Phone <br /> �r0o F�5 MPd 1`ca� �y�'�'P.rr,S <br /> Tenant Mail Address Gity State/Zip Phone <br /> �rime ��ec�+':c 13301 S� ZGr'� S� F3 ��evv� w� �� ��-7+•�-�ioD <br /> EleCtnCaf ContfaCtor Ma�l Address CiEy SiatelLp Phone <br /> ��1I'���1t3� PT. � 500� °= <br /> State License Number Contract Price oi Work <br /> v��F►c� 5hawn Iaod1 �r <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(!f residential new construction,remodel or addition) <br /> Number of devioes(If low voltage) <br /> taescription of work to�oone: AdCI (.'�.) 5 0 a mv h�a�-er o u�I e-E-� <br /> F�E � <br /> ClTY OF EVERETT LOCAL SALES TAX CODE ES 3905 �� '� � <br /> l hereby certify that 1 have read and examined this application and know fhe same to be true and <br /> correct. Al!provisions oflaws and ort�fiances goveming this iype of work will be completed <br /> whether specified herein or not The granting of a permit does nof presume to grve aufhodty to PERMIT# <br /> violate or canCe!the provisions of any other stafe orlocat!aw regulating construction or the <br /> performance of consfruction. That!arn autho»zed by the owner af this propetty fo perform the E ��-�C �.�. ��� ; <br /> work for which application is made and 1 comply wifh the State Contractors Law 98.27 RCW and ?' <br /> 296.200 WqC. • <br /> � <br /> :%��'�- %'6s�� 01 - 10 -- Za 17 z. <br /> Signature p�e F <br /> � <br /> € <br /> REVISED 320/13 � [' <br /> €` <br /> L <br /> t <br /> �: <br />