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ELECT�AL PER�VIIT 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 />I��a SE _ !� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />1 "S 1 �02 S��-,rE- M�a�.1n <br />Mail AddreSs <br />1� Ylnn�i�-,A� �i:�!' Gl �� i�� S <br />E�ectrical CoMrador Mail Address <br />A�_Prrr`�q l�a �LP <br />Stale License Number (required) <br />��� � <br />Proposed Use of Buildiny <br />Square Footage (If residential new construdion, remodel or additionl <br />Number oi devices Qf low voltage) <br />City <br />City <br />City <br />State2ip <br />�_7�I—I� <br />� ,So� -0�3 <br />Phone <br />�4z5� <br />�� "I i r�-►nr <br />Phono <br />yas;3�— <br />Phone <br />iZS�--I �13"1 �-I <br />Ciry of Everett Business License Number (required) <br />� V � 5� C� �---' <br />Conlract Price oi Work <br />(�}� 'M-P-�'1-C�rt. �?�32�-21� <br />Contact PersoNContact Number/Email <br />I��/I'S1-Tr� ((��UECUS i UYV� . �UVv� <br />Description oi Work ro Be Done: � �� �2-r-� � �� ����� �� � �5 ��u� G r <br />�n� ����s <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerh'fy fhaf 1 have read and oxamined this application and know (he same to be frue and <br />corrocf. All provisions o/laws and ordinances goveming this type olwak will be complefad <br />whethar speci�ed herein or no(. 7ho g2nfing o/ a permit does not presume fo give aufhority fo <br />violete or cancel the provisions ol any other sfate or local law regulating constn�cl�'on or the <br />peAortnanca ol consfniction. That 1 am authorized by the owner ol this property to peAorm fhe <br />work for which application is made and 1 comply with fhe .Stale Confractors Law 18.27 RCW and <br />296100 WAC. <br />REVISED 0&965V t� <br />FEE <br />8� 75 <br />PERMIT# <br />E(5o( - �73 <br />