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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-25'-8810 - FAX 425-257-8857 —wv✓w.everettwa.org <br /> ��61 � �d.F,v ru� G(>y <br /> ��:��-���, ��u f �=r,�e.�-tf Gt/1� , �l 8Z o � <br /> PROJECT ADDRESS <br /> ���S� ����5 <br /> Ov er f.lail Address City State.'Zip Phone <br /> ��vt�e�r I12t l� 5 <br /> �T ant tdailAddress City StatelLp Phone <br /> �/�15�t'`jt �/�t��a tis /)D f� ak �3 4 8 ,��.�✓�i. G✓f� , `��Y� �vzs�z �e7 <br /> Elec(riCalContractor �dailAdtlress Cily Stal^_/Zip Phone <br /> � 5�sw 100 ��� bsU� z 9 <br /> Stale Lice se Numher(required) City of Everetf Business License Number pequired) <br /> �� h S/� �1 � ° � � i <br /> Proposed Use of�uildmg CoNracl Price cf VJork i <br /> Square Footage(I(residenlial new construction, remodei or addition) Contact Person!Contacl NumbedEma�l <br /> Number of devices Qt low voltage) <br /> / / r!' �.. <br /> Descrip(ion of Work to Be Done: �G� " � �L� ` � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 l O(/ • �O <br /> 1 hereby cerfily Ilraf I have read and examined Ihis applicafion and kno�v the �ame lo be frue and _ <br /> correct. All provisions ollaws and ordinancr.s,oveminy lhis type o/v.�ork�vill be corrrple(ed <br /> wlie(her speciiicd heiein or noL The granling o(a penni!does no(pmsume fo give aufhority fu p[RM1T�t <br /> violafe or cancel(he provisions olany ofher sla(e orlocallmv regulafing consfiuc(ion or fhe � <br /> perlomiance o(construclion. That I am aufhonzed by fhe o�vnerolthis propeRy fo pedomi fhe ''�D I _ � 35 <br /> �vork Ior�vhich application is rnade and 1 corr.ply tvifh fhe Slat� Con(iacfors Law 1827 RCW and <br /> 296.200 WAC. � <br /> , � Z7 �� <br /> 5 fure Da <br /> �:ewseo o.ecam+ <br />