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.`�� <br /> <:.,t <br /> : __� <br /> ':,;,, <br /> �� <br /> 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 /> . r� <br /> �;.�, <br /> ��: <br /> ;�•,i <br /> :�yi 7 S�-�,� r�i�� � <br /> PROJECT ADURESS yZs 9� <br /> �'-/�,�5�' <br /> �o y� %/ ��i 7 �i-�, �/� t��/l ��'�i�'� ��Zc.'/ <br /> Owne� � Mail Address City SlalelZip Phone <br /> ;�nant MailAddress Cit StatelZi Phone <br /> Y P /�'1,Z7S-h,Z S._ <br /> �i s,''`f �r/�/s'lF-1 ��' /��' �C,t� �% �1�J h �- /�ce l�(/i�� 3�y..Z,�sc� ;� <br /> Electrical Conlractor Mail Address City State2p Phone �' ;� <br /> t z;�� <br /> GG� ' � <br /> /'L C /45TLG% OC?n ,L � � 5 n(,2��� <br /> Contract Pnce of Work �;+}�; <br /> State License Number . <br /> iYV1il]!/�`Y'�iCY'L1Yi �•1`7 `F!'s_'', <br /> Proposed Use of Building ' Contacl Person (Plan Review) .- <br /> 35�-�-' <br /> Square Footage(If residential new construction,remodel or addition) <br /> G�' <br /> Number o(devices(If low voltage) <br /> Description af Work�o Be Done: !�C '� ''" ��.'��/�- ��� �u� ' 'y5 ���1 � � �1<c.�J h'� <br /> /� �/�� r7�, 9C'✓CXS /I//P�-, �✓'-'��l /'i���i:l 'e '//l,'s-.l _ . <br /> x <br /> �:� <br /> ¢_' <br /> FEE ` <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 -,���,� � C� C� P�' <br /> I hereby ceRi(y that 1 have read and examined this application and know the same fo be true and � ��> � <br /> correct All provisions o/laws and ortlinances goveming this type o/work will be completed ":h� <br /> whether specified herein or not. The granting ol a permit does not presume to give authority to pERMIT# <br /> violafe or cancel fhe provisions of any other state or local law regulating construction or the � `'! <br /> peAormance ol constniction. That 1 am autbodzed by fhe owner o/this property to peAomi the E I '�O�j - D"�� ' <br /> work lor which application is made and 1 comply with the State Contractors Law 18.27 RCW and �� <br /> 296.200 WAC. ' ' <br /> / Yp I <br /> Ci,�..—l'j � ✓L'' ' ��/[-�l0// 5 � <br /> Signa�ure —�a� ����-:"� <br /> � <br /> L REviseuaeau <br /> � .. . .. � . .._ _ � � � �, - <br />