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OL/Q3/201d PRI 10�31 PAX <br />• <br />�LECTRICAL P�ERMIT APPLICATION <br />CITY OF EVERE:T'T PERMIT SERVICE� <br />3200 CEDAR STREET, EVERETT, VVA 98201 <br />425-257-8910 - FAX 425-257-9857 - www.everettwa.org <br />/�fl� 5' � �i9 W��- M�\ l.ci�wy <br />PROJECT ADDRE83 � <br />�� 'I � . � �.�.in � G' G iil/'�.J� <br />Tenenl <br />Mell Addreee <br />MBII Atldraee <br />Clry <br />/� <br />Clly <br />Slatel2lp <br />�001/001 <br />Phone <br />Phono <br />%��d�_��ec�l4`� J� I.LC �o::.� n�l�lb�, �.'0ia� i3;;r�„j` Cc�J� 3E�•�v�$� <br />EIeCMCaI ConVBCtOf Mall AddreeB Clly 9lete/Zip Phone <br />� 'v\ n � <br />S[ela License Numb9� <br />(nJA-� � ST6�'� <br />Proposad Use of Bullding <br />Squere Footega (It residentisl new construction, remotlel or eddlUon) <br />Number of devlces (If low val�epe) <br />Description o( Work to Be Done: <br />CITY OF EVERETT LOCAL BALES TAX COOE IS J106 <br />Contracl Price uf Work <br />Contecl Person (Plen Revlew) <br />I hereby ceKl/y thef I hevB teed end exemined lhia applicefion end know fhe same fo be Irue and <br />correct All provlalons ol lews end ordinences goveming Ihis type o/ work wll! De c�omplefed <br />w;;e�harspecilied herein or no(. The granflnp ole permlf does not presume ro pivo authority to <br />vrolate or cence/ lhe provlalons ol eny ofheYstete or local !aw regulating consfructlon or (he <br />peAormanCe o ansfrti h'an. Thet ! rriaufhodzed 6y fhe ownero/�hls propeRy ta per(orm fhe <br />work forwh�ppll on le med nd I comply wllh fhe Stele Conhecfors Law 18.27 RCW and <br />286.200 WA' <br />�� �' <br />nevrsEa.sao7� <br />FEE <br />�l���b <br />PERMIf# <br />� i`�o(—a15 <br />