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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 5�ap--13 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8610 - FAX 425-257-8857 —www.everettwa.org C�3 fJ S'��� <br /> � �Jr�;�- ����, nr I� � --- �� �,���;^� C�- <br /> PROJECT ADDRESS <br /> Owne� Mail Address City State!Zip Phone <br /> r <br /> Tenan� Mail AdAress City Stete/Zip Phona <br /> •3ro - <br /> �A�I , t � �Ih� r: � .,Ir � � I�u'1'h��'�_I 1�, � i � S 9�1-Ik65 <br /> Electrical Con��aclo� Mail Address CAy Stele2�p Phone <br /> � �1JNlC� c�% 77 � �� fSCw <br /> Slale License Number CoNract Price of Work <br /> � , �l;tl��l <br /> .. <br /> I'roposed Use of Duilding Con�ac� Person (Plan Review) <br /> Square Pootage (If residential new consiruction,remodel or addition) <br /> I Number ol devices (If low vol�age) <br /> I <br /> , Description of Work to Be Done: �0 C4T�C i� �'v�� � � � � � '` `��` ��� '� �I <br /> � �G..�� ti> G �. '�' ` � <br /> FEE I <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 L)� . �� <br /> ' I hemby cerirly thnf I hove rend nnd exnmined Nris npplicafion and Anow Iho same fo Go hve and <br /> � conocf. All;�rovisrons ollaws and orAinvices governing fhis type ol work will bo contple(eA <br /> . chefher spuci6ed berein ornof. The granting o!n pennit does nof prnsumo to givo nuthority to pERMIT# <br /> vrolafe or cancel(ho provisions ol ony ofher slafe o�local law regulafing constn�cfion or fho <br /> �� pmlorrnance o/r.onsfn�cfion il,nf 1 nm aufhorizod hy fhe ownero/this property to pedorm fhe E ( ��5 ' 'I �'J I <br /> r;o�k lor which npp6cation is rnado nnd 1 comply with th�S�nte Confrac�ors Low 78.27 RCW and — <br /> �� 296 200 WAC. <br /> /'� C <br /> � <br /> , I ��'� 7 i_��I 5 <br /> II _ � .. � _. ._._--- —�Date <br /> .��SID s�ure' � <br /> ... , .. �. � _ . . _ .. ._ --- -. _.. .--_.._ . _— __ ..-------� - . _.. . ._ . <br /> - <br />