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� <br />ELECTRICAL PERM�T APPLICATI4N <br />1����U <br />PROJF.CT qDDRESS <br />CITY OF EVERETT PERh71T SERVICES <br />3200 CEDAI: STREET. EVERE7T, WA 98201 <br />425-?_57-8810 - FAX 425-257-8857 — w,vw.everettwa org <br />hlail A4Cress <br />/1� <br />C�ry <br />State2p <br />Phonc <br />�1't,( ri�'n U' �i,r'.rr �� << <� �IZS_25°�-�i i o0 <br />Tenant �dad AAaross Cay scaiemp anona <br />►�arr <br />Contractor M11ad Atldress <br />�P,�2, �'j a- °J I � <br />State License Number <br />Pr� ed Uso ol uiltling <br />� <br />Square Footege (It residential new construclion, remodel or addition) <br />Numher ol devices (II low voltage) <br />City <br />�.� °l�2 � <br />S�ate2p Phone <br />a� �21 oc�. u� <br />Con�ract Price of Work <br />�,t�t�.� i ur�r� <br />Contact Person (Plan Review) <br />Descnption ol Work to Be Done: � �)J��L ' > � � � C ( �(�{ I T �2,, ��j�"'� �_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 he�eAy cerLly tlrel l have rearl anJ examineAlhis appbcehon and hno�•: 7he seme to be fnie and <br />correc( All provisrons nllaws and orAmances goveming 7his fype ol work wdl be complefed <br />�vhefher specified herern oniot. The gr�n(ing ol a permi( does nof piesume (o give aulhonty lo <br />v�olate or cancel the provislons ol any ofher sfa(e or locaf !aw regu/a(ing cons(�utfmn o� (he <br />peAonnance ol consl�t�c7io��. r��of I am aufhoiized Ay (he o�iner ollhis properiy fo perfomr !he <br />work lor which applic�Vion Is made end 1 comply wqh (he State Contracfors Law 18.27 RCW and <br />296 200 WAC <br />�i <br />REYl,'�EO $21�13 <br />FEE <br />��5 � <br />PERMIT# <br />ElybB-o�S� <br />