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_-- - __ _-- -- — --, <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> l25-25i-8810 - FAX 425-257-8857 —www.everettwa org <br /> �sc� �1 Cc1(�`-�O-rn irr� ���.1-� , l� A �BZo � <br /> PROJECT ADDRESS <br /> Owner MailAdd�ess Cny State2ip Phone <br /> ��•, $� voco.c (�,�-✓ �So�1 �����+��,�� �� w� q�2o \ <br /> Tenant Mail Addies3 City Stale2ip Pnone <br /> �AJ.uaM(e� Lltc�,.u��Solo��o-�s (.l-L 21 �ls+AoLN� (aNiSk�`'� W� �1 BL58 �C{��il3 SL3,� I <br /> � <br /> ElecVical Contractor Mail Address Cily State/Zip Phone <br /> AbVA �J �-5 �7� N� A ?oo ,.`' <br /> S�ate License Number Conlract Price of Work <br /> C�i��� p�U4lw� � <br /> Proposed Use of�uildin Conlact Person (Plan Review) <br /> Square Fcolage QI residen�ial new consiruction, remodel or addition) <br /> � <br /> Number ol devices (tl low vollage) ' <br /> i ` I <br /> DescriptionolWorklo�eDone�. !i ti�� ���(J�`j 110J ���`.��1tt�_ �V AWay �70w� <br /> i /1 �1 / <br /> rrNLl 1N Fa�tly ✓ouw� "fwa /�'�C /aylLt YJh _ Ct�x,yG T��ir� T� <br /> e�,r;( 1�., r i �i �t r , �w I� /fc t�'�a c.lt— --- <br /> i -- — ---�-- <br /> -- �------ <br /> � FEE <br /> � CITY OP EVERETT LOCAL SALES 'fAX CODE IS 3105 (�?J .�`� <br /> u, <br /> �h��rrby c�ibly�fhat 1 hnve reod anJ exanrined fhis npplic�fion f�od hno�v(he samo fo bo fmm�nd <br /> �.��nect �li pn�v�sions o/latvs i+nd ordir�ances goveming fhis typo ol tvork ivill bo comple(ed <br /> ��,hethnr specdicd hnrcin or noL The y�anfing ol n pennit does nuf presumc lo givo aulho�ity fc PERMIT# <br /> :�olalc o�cencel fhe provisions ol nny ofhm�slatc or local law rogulnfing r,onstn�ction or fhr. (, � <br /> nerlonnnnco o/cnnstnicfion. Tht�f I nnt nuthorized by the oivner ol this piopert� M pedorm the E I �'��� - I U <br /> r.v�k/or which applicntion is mndo anAl comply with fhe Sfido Confmctors Law 18.27 RCW and <br /> :'96 200 W.4C. <br /> `— y� <br /> � � _ , , .p /9�/ �i <br /> �i � Signalure �ate <br /> /% <br /> i <br />