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- -- -�-- w- --- � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857 —ww�v.everettwa.org � ���/Cr <br /> � J � � Si�vt��nk� �� . Svl�t ,`) <br /> PFOJECTADDRESS �Q � ^Z y��� �,0 <br /> �p��y � �ofF�<c l��l S �(v{fJ��,, �1 s��C(� ���� 1, ��- �8 � �` s i � <br /> o�,,,,e� g�E tdatlAddmss Gly Slate2ip Phone <br /> � <br /> TCnan� IdadAdd�ess Gty Statc2ip Phone <br /> ,� OT �� :- _ B�- �.t`�,. .p6Cw, N �lo>y I��,�ll ���A y�� �o�-7r�+��ry� <br /> [Iectrico.Ccnlractor I�1atl�ddress C�ty � State/Lp Phone <br /> � � °6 �' <br /> A DT�L� �8(� � <br /> Stalc License Number Contred Pnce of Work � <br /> C��,�h�/z��/ en�ti�_L�,_wl� � <br /> PioposcA Use ol Dwidmg Contact Person (Plan Revmw) <br /> I <br /> Squ�ie Foolage jlf residenUal new construclion, remodel or addition) <br /> �"_�+��«�S <br /> Number of devices(If low voilage) <br /> i �r n' / / � / <br /> Descnption of Work�0 6e I)one�. yI���vf�� �.�ct/�i� �{1 ,>��(� �Dn ��� ���1�.U�fd, - <br /> ✓ <br /> FEE <br /> CITY OF EV[RETT LOCAL SALES TAX CODE 15 J105 �D U6 <br /> I hereby cerirfy fhaf 1 havc read and ex,vnined fhis�+pplicafion and Imor✓Ilre samc lo bc Iruc and .-- .._---_--- <br /> cormcf. �II provisions o(la�vs.�nd ordinances govemm�Ihis(ype ol work vnll be cnrnplefed <br /> �vhclher specdicd hr.rcrn or no(. Thc granling ol n perrnif dor.s not prasimie lo groe aulhonty(o PFR��II i�J <br /> v�Ulafe or cancel(he provisions o(any o(her sfn(e or local law rogulalmg consiruchon or fhe � I � / D ( — D , /� <br /> perlo�mance o/consln�c6on. Thaf I.am aulhonzed by fhe owner o!fhrs property fo perlorm fl�e ('� y <br /> �vork lor which applicafion�s made and I r,nmpty wrth!he Sfafe Conb.icfors Law 18.27{tCW�nd -_---.-_- _— -_-. <br /> 196.200 LV�G <br /> ` OFI�f- ---- <br /> -igna�urc ----� ----- ------- a�c <br /> i <br /> N(''/I'�/>I.:�fi�il I <br />