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—� — �--- -- -- <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, [VERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetlwa.org <br />l!lO �A��it2. %�uE <br />PROJECT ADDRESS <br />EvERSi� (JCr•E�TIC��J/oL�NLEGE�ZLiL- IIIU K'�lNlLL�/�"E !�N'c7�E�_ <br />Owner Mad Address Cdy StatelZ�p Phone <br />� � 2�'a�l <br />Tenant <br />Eleclrical <br />s uNC-�5 = 9oS ��( <br />State License Number <br />M11ad Atldress <br />Glad Address <br />�l OH�STI�. IiIOLG^�aE �/GYlN1 �7vUS/N� <br />Proposed Use of Building <br />Square Foolage pf residen�ial new consiruction, remodel or adddion) <br />of devices (If lo�v vollage) <br />City <br />C�.ry <br />StalelZip <br />Phone <br />StatelZ�p Phone <br />��Oi7 d-�%7—OacJ�(n <br />�i,�3.eS — <br />Contrecl Price of Work <br />�,�o� /IEN� F,��� <br />Coniact Person (Pfan Revlec�) <br />���� Z o6 - 39o-.S3��( <br />DescriplionofWorktoBeDone: ClT��/T� %�En P�1�TovOLT�41L j�v{)-�y� ��,NSIS77Nfr <br />CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br />I he�e6y ceRi/y fhat I have �ead and examined fhis applicafion and know the same (o be f�ue and <br />coRecL All provisions o/ laivs and o�dinances govemin9 this (ype ol �vork �vill be compleled <br />whefherspec�Iied herem or noL The granting ol a permif does nof presume fo give authonty (o <br />violafe or car,cel lhe provisions ol any other sfafe orlocal la�v regu/ating cons(ruclion or fhe <br />pedomiance ol cons(n�ction. That I am authonzed by the o�vnei oI (his property to perfonn fhe <br />r:ork lor �vhich applicafion is made and ! comply �vilh the SIa(e Confractors La�v ]8.27 RCW and <br />296.200 bVAC. <br />�/-d —ao! <br />=ev�s�o vaa-r� <br />FEE <br />� <br />aeRr�rr� <br />E131) -OZ8 <br />