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ELECTRIGAL 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 />1� 0� SE F �e�.e�� �1 �LL ���� <br />PROJECT ADDRESS <br />�( --30-� 3 <br />�i3o�f�i� <br />\`�'1i�U� 5 • � � <br />OWOCf Ma�t Addrecs City Stute2ip Phone <br />��i��5�'1�\ <br />Tenanl <br />�� <br />Mail Address <br />S���v� c�FS�1'�L� �a� <br />GecVicalComractor Ma�lndamss <br />SYti'1E`�US�(�f���� <br />Sla!9 LiCense Numher <br />����� <br />Proposed lJse ol Buiiding <br />Square Foolage Qf rosidanGal now construction, remodal or addition) <br />Num6er o(devlces (11 IoW vollaga) <br />Doscription of Work to Be Done: <br />� r, ��l u-�!ex <br />CITY Of EVERETT LOCAL SAL[S TAX CO�E IS 3105 <br />City <br />State2ip <br />Phone <br />Cily Slato121p ��opy <br />i� <br />� } ,1x9('j <br />Contract Prico of Work <br />b�1151in �UIi�C�. <br />Contact Person (Plan Reviowq) <br />Pr!'v 1 U v� lV�� <br />f � y`� � l� . <br />1 horoby cert�fy that 1 havo road and axem;ned !h!s application and knowlho samo to be true and <br />carect. Al! provisions o!ln�vs and orrJinancas goveminp this type o(wark wilf be compfeted <br />whether spedflod hororn ornot The pranting of a permit does not presume to g�Ye nuthonry to <br />� Ioiefo or cance� the provisions of any other state or locaf law regulaeing eons7rucfion or the <br />pe�form�nco ol construclion. That 1 am auGio�zed 6y th� ownerof this propnRy fo porlorm the <br />wo�k lor wbieh applicafion is made and ! compry withlhe Stato Conhactors Law 18.27 RCW and <br />296�OOWAC-. / llt/ //n` t�/2�11r% <br />�I <br />FEE <br />7Z�� <br />PE�MIT# <br />�1304— lgC� <br />7.f� 39ttd LLLh89S90� i5:80 ELOZ/OE/V�l <br />