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70. Fermrt Services Page 2 of ? <br />�iZ�� <br />20�4-�1-V 23��4.21 (GMT) <br />• <br />• <br />12532690269 Prom Enc Olsen <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEOAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—vw'nN•everetriva.org �/41`�, <br />���i8��� <br />.�- /�c,po�.��l b-� E <br />PROJECT ADDRESS <br />� Owner <br />Tenant <br />Ma�l AtlCress <br />Aleil A4Cre5s <br />Ciry <br />Clty <br />State2ip <br />SIaINLD <br />Phone <br />Phone <br />�lsen Ct�t-�,c- aa� w�.,h,�uk� a�s-��t 1�,�- ��ra ��uda <br />EiectncalContractor Ma�indaress C�ry Sea�e2io�T3-82R-l4��e <br />�.c��.s�Nc��aie�= �coa <br />Scate L�wnse Number (reQuired) Ciry of Everett Business License NumDer (reqwred) <br />/' ��; UUv <br />i IMMil. l._' � <br />Pwpose0 Use of Bwltlmg Contrect Pnco o( Work <br />J�s� C�wn�x�= o253-e�a-lyas <br />Square Footage Of resioential new conslruclion, remodel or atld�Uon) Conlacl PersonlConta NumberlEmoil <br />� Number of deviu:s (If low vollage) <br />I <br />� 5 �V � C� G.�n r�e��4-Pu,�S <br />� Doscnpt�on oI Work lo Be Done. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7106 <br />I hmr�by cenity fhnt ! havo rood and e,ommod th�s aFplicefion and pnow the same (o �o Wo ond <br />corracf. A!f provisions ollcws ond oriimances govemin9 tb�s ryPe OI �ti-urk wi0 bB completed <br />wlr�thor spoc�fioU hoioin or not. The granhna ot a pomtd doos nof presunto !o givn authonty to <br />���olam or cancol tho provaions of any othor sfata or ioco� iow rogulaGnp consfruChon or tho <br />poAonnenco of construcrlon Thal ! arn nulhorrzod by fhe oa�no� ol fhis p�oparty fo poAonn Iho <br />tivork lor which apphcalion �s meAe ard 1 cOmply wifh the SfAfo ConlracfOrs Law 782i RCW and <br />29fi.200 WAC. <br />S�gnatura D�le <br />..�,,.�.-��w..�:a,. <br />FEE � <br />I�ZG� <br />PERh11T# <br />EI II-is� <br />