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. _ __._. ... -- -- - -- ------ ----- -__ . . . --- - --�i <br /> i <br /> ELECTRICAL PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES I <br /> I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257•8810 • FAX 425-257-8857 -wvnv.everettwa.org i <br /> �_� so 5-1/� I� <br /> � '� � — � � �'� S I <br /> I I I �(� SE�Ev�,—�-i-l- n��� w��_ �I <br /> PROJECT ADDRESS � i <br /> II 5 �u� � n,,Fs�. �c��a �,��P�..,,-o �,� C��-�,�, o+� y��.� i <br /> �, Or:n� �.ta�,l 1dCrrs, Cdy Slate,Lip Pnone � <br /> ' S1eEc�Ti-�' n ��/S�! �i�.r< f�c �c5+on ix 7�3- 3v3- 3c-r�' <br /> �enant L!ail Addre, GPi SlatelZip Phone �� <br /> � ��<,� -�iC��; o?OI`Z ��el��✓�Z'..9 �c1 �r'[l�n�ltc�M � `�•�aG '-�o•G,l/-/3N3 I <br /> ;, Llecincal Con�iaclor A1ail Aderess Cay State2ip Fnonr, i <br /> I �i6NPi ��c�c� P� �I�(o � I'� <br /> � Slate License Numher(reqwred) Gry ot Evere;t Bus�ness license Number(required) �i <br /> � r�-(c�a <br /> `�BLYX��' I <br /> Proposed Use�I EuilC,ng CoMract Pnce ot Work <br /> �cx-ce-�31v-;"-4- 3�-.�'-�. 7� • �3`-�� <br /> or,e C��1.¢- s%� Co�+'� <br /> I Sqaare Fuotage(II residentlal nevr r,onsVuction, remodel or aAdition) Cor.tact PersonlC�ib�mail <br /> I <br /> Number of devices Qf low vcltage) <br /> Descnphon ol Work l0 6e Done� Y� c '� ��� � 'Y ��� ��'� � S �ul <br /> � 1'`2u� (��C'v n rn,� �_ �� dL� - � 5 C� � <br /> J <br /> � II <br /> I FEE <br /> '� CITY OF EVERETT LOCAL SAL[S 1�AX CODE IS 3105 l� J�"�- <br /> I <br /> � I hereby certdy lhaf!hove read and exammed Ihis appli�a6on and know fhe samc fo be fruo a•id <br /> correcf. �0 provisions o/l�ws and ordmances govemmg thrs type ol wnrk �v'I be completed <br /> whefher specilied herein or no(. The gran6ng o/a permrt does no�presurne fo give aufhonty(o PFRP1IP,t <br /> violafe or canccl fhe provisions ol any ofber sfate or bcal law regulaf�ng constiuchon or tho � 1 �O�! f � � <br /> peAomianre o/consWction. Tha(!am authonzed by Ihe owner o(tfus property to peAomi fhe � � <br /> i work!or which applicafron is made and 1 comply with fhe Sfate Contractors Law 78.27 RCW and <br /> ! 6 200 AC. <br /> � ` <br /> � t-�,C.. � 5 �l�Jls <br /> � S�gnature Dale � <br /> r.p�vu:Tm"a'.;:_ia <br />