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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 425-257-8857 —www.everettwa.org <br /> �� � l GJ�/' 1;�,u,y (�f`` � <br /> PROJECT ADDRESS <br /> G� �5��h +- 1�ssoc _ 3�-�. 3 - rs �}t,L�. ss go��i� W�- 9�1 o �z <br /> Owner 61ai1 Address City Slate2ip Phone <br /> ��' ✓' S -� y �1 � S �b S 4y Il �J'i��.xt� W^� �✓r�{(--�- tiIA <br /> Tenant � IdailAddress Ci� State2ip Phone <br /> l`� �, ti I S�n'`5 ,�c . yo �eF 8$G �v��,i�,.v�o � �,t/ �4- ��Z � 5 <br /> Electrical�clor 67ai1 Address City SlatelZip Phone <br /> � � 5'{5 � � ?� 7��,� 0'�9 � �t�1 <br /> Slate License Number(required) City of Everelt Dusiness License Number(required) <br /> ���-ou <br /> Proposed Use ot Building CoNract Price ot Work <br /> ��E'(l�n � �� 5 TS�Cv�� S <br /> Square Footage pf msidential new construclion, remodel or addilion) Conlact PersonlContacl NumbedEmail <br /> � �- S �-k'� 5 <br /> I���,,�Ep��5�s-1-r�-�s �%,�. ��<�,, <br /> Num6er of devices(If low voltage) <br /> \ <br /> Description of�Vork lo Bc Done: �-f' ID C � � i/� ���� ����`'� r� �✓`"��!� � _ <br /> wl �C S �/ �� /1��� �2��0� 1-�'�5 <br /> � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � C � <br /> J <br /> I hereby ceAily ll�at I I�ave rnad and examined fhis applica(ion and know fhe same fo be trt�e and _ <br /> correct. All piovisions ollaws and ordinances goveming fhis type ol�vork�vi116c complefed <br /> v.f�efherspeci(ed hemin orno(. The granting of a pemiit docs not pmsume fo give autharity fo PERMIT� <br /> violate or cancel(he provrsions oI any olher sfate o�locallaw mgu/aling consfruction orfhe E � 15Q L-C�z <br /> peAomiance o/consfruction. Thaf I am authonzed by the ownerol(his property fo peAomi the <br /> �vork lor which applicalion is made and l compty�vilh the Slale Contractors Law 18.27 RCW and <br /> 296.200�WAC.R —__ _ <br /> � i �" 2- L- 1S <br /> gnaNre Date <br /> RcN5E00fl962GIJ <br />