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ii <br /> ELECTRICAL PERMIT �4PPLICATION <br /> CITY OF EVERETT PERMIT;SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 : <br /> 425 257-8810 - FAX 425-257-8857—www,everettwa.org <br /> "�`'�� ��cf,�(t-� ��� ���`CT <br /> PROJECT ADDRESS � <br /> �i��-/�� C��E�` �Q � �� 3�U 70 f � cj� �' <br /> Ownel' Mail ddress City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> . . . <br /> �� �,.�.��'rec�� , � ���� ���� �//�t �r �ab�°�r 3,� o <br /> , <br /> ElectricalConfractor i�ll,� MailAddress Ciry StatelZip'- Phone <br /> ) <br /> ��-� � g �-� . . � � l . _ <br /> State License Number(required) / Gity of EVerett Business License Number(required) <br /> � ���o� <br /> Proposed Use of Building Gontract Price of Work <br /> l�� ��-��. N1�M�.�,�s �b 2-7� ��7� <br /> Square .ootage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> r v�CJ`1�/ � ��7�'o�r�- Zj iJ�-V : _ <br /> Description of Work#o Be Done: IQ� G�✓t �/--t'� <br /> i�'i/ ... �/t�G��° ?� �� ��--�" C l.c..-�—� r�.v�S�P�.� <br /> � : �01�5� �aE.�S �t�c�t. � � <br /> �� ��`'�'` � <br /> FEE <br /> ` CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � � `1� �D <br /> _ � <br /> 1 hereby certify that l have read and examined this application and know the same#o be true and <br /> correct. All provisions of/aws and ordinances goveming this type of work will be complefed <br /> whether speci�ed herein or not. The granting of a permit does not presume fo give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the � �� ,`�� ��� <br /> performance of construction: Tliat I am authorized by fhe owner of this properly to perform the (� <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WA <br /> ` � <br /> !� ��� r <br /> r <br /> Signature Date <br />