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� � <br /> - _ _ � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR 5TR[[�, EVERFTT, WA 98201 <br /> 425-257-8810 - FAX 42�-257-8857 - w�wv everetlwa org <br /> � S ' ��►`l <br /> �. we�ti C�s��Q�L— <br /> PROJECT AD�RESS <br /> �t f VeYp�e � <br /> `�e {�lu S._—�__}—�- ----- -------- --- - <br /> Owner r:tadn ,�tless cdy state2�p Pr,one � <br /> I I <br /> � �1n�����-��\�- SI„�..0 �. 1�C5�Ct�S\�o�\ _��l�c.t�1v�A <br /> ilenanl �Address--- C�iy -�-� �� Slale�Z�p 1�-- Pnone <br /> I�v��������ue�.lQ�.�c�c__t���x_y3qa__ _f'�ece -� R Zoti__yz��-_v__oz�o i <br /> i ❑eclncai Conlractor ',7aJ��:C�ess G!y Slale2 p Phone <br /> � <br /> ��"'� OOQ.�O � <br /> �111_N�_��i`� K E co�,�aci r� ce o��r�o�k — i <br /> Siate L�cense Nurnber � i, <br /> Proposed Use ol Bv�iding Contatf Person (Plan Rev�ew) ' <br /> � <br /> Square Footage (II residenlial ne�v consiruct�on, remodel or addd�on) <br /> i <br /> I <br /> iNumbe� of devices(If low vo4age) � <br /> I /� (�`\ �� 1 , p (� I <br /> ibesr.np6on ol Woik to f3e Done _�l=F-/ `.��1-- __��.��,�� � v- `` --- 'V.�Q.-�� � . — . <br /> I <br /> ��'1 ��'\ _ ����U-� �_ v_1`5.G\^�f�--_, �— ��/41C�\\V_��\ �/- --- � <br /> I <br /> FFE - -- ---- - <br /> CITY OF EVERETT LOCAL SALES TA% CODE IS 7105 I �� �O <br /> i <br /> 1 hcreby ceri�ly(hal I havr. rend and cramrned fli�s uppl�cnhon and Fnow flrr, same fo be frue and -- —.---'---- ---- <br /> corrrcf All provisinns o/laivs and uid�nances goreming Ibis fypr, of�vork wdl be cnmpleled �—'- ---- ...--�—.... ._... <br /> �vhelher speobeAlir,rein or nol. Ihe yranhny ol a pemnt Aocs nol presurnr. (0 9ivc auNronty fo PFRMII4 � I <br /> �iol;de or cancel fhe prowswns ol any oN�er slale or local law regula6rrg consf�uchon or fhe ( E I y 05 - �u 8 <br /> peiformance ol r.onshucfion Tfraf I:�rn auffronzcd Gy�he o�rne�ol Ihis property fo peAo�m fhe <br /> �vork/or�vh�ch apph�.almn is madr. ,�i J cornply�vdh !he Sfate Conhacfors La�v 18 27 RCIh'and __ . ._ ____. ' <br /> 79G 200 WAG I <br /> . <br /> i <br /> - -- - --- � ����y--- — - - � <br /> SignaWre <br /> i <br /> nrrsro v�ar� <br />