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- � �--- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98207 <br /> 425-257-8810 - FAX 425-257-8857 - www everettwa.org <br /> �S'�� Sr - AIL�Y ��ucK"� 4 (-QA�/4 <br /> F�OJECTADDRESS <br /> Owner Mail Address C�ty Slate7LiD Pnone <br /> 3�0•7ST 7S7 <br /> /NTc��CVcST COMXr�QkGTi��V� Irve �05 Il�� Ni� �,w0_duRt�,�67eu,W�9 q8dS3 <br /> Tenart MallAtldress Gty ;�:n'Zip Pl+one <br /> �qdL ELECT�QIL �4D�i I"�YJ.7iL4NLL AVE Evc,2:a !.,b `•i`6�Di y�r•1f.1-I�oc <br /> Electncal Contractor nnau naaress Gry State.2�o Pnone <br /> �ANLLEI h1LQD � � � � �� <br /> State License Number(required) C�ty o(Everelt Bus�ness License Number(reqwred) <br /> �ao ^ <br /> Proposed Use of Budding Contract Pnce of Work <br /> 1'ru ST�VE►!S 3L0 -L�sl •OSII <br /> a�stevtns(�d�.l.l��eetric.ca:v� <br /> Square �ootage pf residenhal new construct�on,remoAel or atltlrtion) Contad PersoNContact NumbedEmad <br /> Number ol devices(If low voltage) <br /> OescnplionofWarktoDeDone TEMF �i{3�Bf�<T/OlJ .�EkVrG� <br /> - FEE - <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 D� <br /> �D_--_ _ _- - - <br /> --1 fiereby ceR�fytha(1 hove7edd-and exarninedYhis�app6cation-dnd�6'now7lre sarne7o�Ue-Iru2 dnd� - � I� <br /> conecf. All provisions o/Wws and ordinances goverrnng fhis type o1 u�ork wdl be completed — <br /> �vhefher SpecJied herein or not The granting o!a permil does nof presume lo grve authonty fo PERM[Tt/ <br /> wolate or cancel the prov�sions ol any ofher sta(e or local law�egulatmg cons(ruchon or the <br /> p��dormanceolconstruchon Thaflamaufhonzedbyfhr. ownerolthispropertyfoperform(he E �50 �-D$(� <br /> wa.N 7a which app�ication is made and i comply�wth the State Conlrac(ors La�v 1H.27 RCW and <br /> 29G 200 WAC <br /> �u�. � 3 ' � 7 - IS <br /> Signaluce Dale � <br /> r,c�bEnea^6ao � <br />