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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMII' SERVICES <br /> 3200 CEDAR STRE[T, EV[RETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> �`ll �i �1 �,-_� �� z a � c �.a c; <br /> � -� <br /> PROJECT ADDRESS <br /> ��:,_<�o f �G�,Yet�-( <br /> Owner Mail Address City Slate/Zip Phone <br /> C,' r=C �aii c- ti'F r;ce• �31�%/���«� ;<</�sn�y <br /> Tenant Mail Address City State2ip Phone <br /> 'S'�� C'72. <br /> /� C � . � t G c <br /> /-� n lE�� j�'.lric:)�,��.� Jc'/,$��IiCi.;z71 � �Cr r' (��'f',N�O `�7D.�,� ✓i3- �� /-i&,/( <br /> EI� trical Conlfaclor Mail Address Ciry State/Zip Phone <br /> /� C <br /> hi I -S �C•��I� ��'�� <br /> Stat License Number Contract Price of Work <br /> �r74 � / — <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � ,� <br /> ' >�' <br /> Square Footage (If residential new construction, remodel or addi�ion) <br /> � <br /> Number of devices(If low vollage) <br /> Description of Work lo Be Done: ���S r`2 �/ � ���1--.� <i� ���� �/�/}T,,q� � /����� l �� <br /> / /' <br /> ')C? / C C' �l �(,r(.- <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �O �� <br /> I hereby ceRi(y that I have read and exemined this applicalion and hnow the same to be 6ue and <br /> correct. All provisions of laivs and ordinances goveming fhis type o(work will be comp/efed <br /> whetber speci/ied herein ornoL The granfing o(a permit does nof presume to give au(honty to PERMIT# <br /> violate or cancel the provisions o/any otherslafe orlocallaw regulatin�constn�ction or fhe r I �� /. ' t � /�_ <br /> perfonnance o(constniction. That I am authorized by fhe ownerofthis�roperty(o peAorm the C �E� I � <br /> woric/or which applicafion is made and 1 comply wilh the Slate Contractors La�+�i8.27 RCW and <br /> �' 296.200 WAC. <br /> � /7 <br /> ')�. !�)�: �r L-�ol�f�/ � <br /> -- ignature Jale <br /> r�ev,e�arzai� -- <br />