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ELECTRICAL 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 />b � p'1—�5 <br />� iso6-��,5 <br />332 � r� �v��V�'l � �� �r/�R�Lru/�4 <br />PRUJECT ADDRESS <br />/JN � <br />Owner <br />Tenant <br />Eleclrical Contraclor <br />Mail Address <br />�K <br />Mail Address <br />. /8�.� <br />Mail Address <br />���D�z"o � �f�� <br />Stale License Number (required) <br />1'1-OM r �U�STP-�77 v� <br />Proposed Use of Building <br />City <br />Cily <br />City <br />State/,'_ip <br />o GI �ii/� <br />Slate/Zip <br />-/20 � Om�,�G <br />Stale/Zip <br />Phone <br />Phone <br />�� ��'DSZ <br />Phone <br />0�� 13� <br />City o Everett Business License Number (required) <br />�/�� <br />ConlraG Price of Work <br />'�DD �7��i' f'u �'�vLc_.o �l <br />Square Foo�age Qf residenlial new construction, remodel or addilion) Contact PersonlContact NumbedEmail <br />� � %✓yt�C���O�t�PRI��-�L�� <br />Number o( devices Qf low voltage) ' <br />Descriplion of Work to Be Done /T�D �D�u` QU�rS ���/���, '`��--�' `� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I here6y certify Ihat ! have read and examined this application and know fhe same �o be frue and <br />conect. All provisions ollaws and ordina e�s qoverning this type ol work will be complefed <br />whefher speci(ied herein or noL The gra ting� ol a permif does not presume to give aufhonty fo <br />violale or cancel fhe provisions of any ot er sfafe or local law regulafing consfruction or the <br />perlormance of trucfion. Thaf 1 am ufl)bnzed 6y fhe owne� ol fhis property fo perlorm the <br />work lor�vJii � application is made and 1 9fnply with fhe Stafe Contracrors La�v 18.27 RCW and <br />nA/ 4/�%l <br />REVISFD OBN6ROIJ <br />,�� <br />FEF <br />�al�•�.� <br />PERMIT# <br />E l�0(� • 015 <br />