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--- - - - -- - - -- -- --_ ---- i <br /> ELECTRICi4� PERMIT APPLICATIAN <br /> CITY OF EVEhETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257•8857 —www.everettwa.org <br /> ly.3z �0� �✓�� .¢c/� <br /> PROJECTADDRESS <br /> �ye �v�s!'��K.�f?�l��x��� �'a rr �v� Pf1�o� <br /> wncr ldad Address City � S�atelZip Phone <br /> ,�s r�`%u� �d�►�9�z����,�ve.,���� r�✓,� � ��s 3�� •o/�� _ <br /> Tenant ldailAtltlress Gry SlatelZip Phone <br /> /� ��4-, G : '�k/E������/'��M/� ,�1�/EP�L l/�i�,�,����1����i.�lr j <br /> Electrical Conlracl r Mail Address C,ry atelZip Phone <br />� /�i��/`��� Q�`//�l� <br /> Slate License Number(required) City of Everett Dusiness License N�mber(required) <br /> �z�� \ <br /> Proposed Use of Building Contract Price of Work <br /> i <br /> Square Foolage Qf residenlial new construction, remodel or addition) Contacl PersonlConlact Number/[mail <br /> Number of devices(If low voilage) <br /> Description of Work lo Be Done: ��G� % `4�.alu�� ���G1 Pf� � `L�th� <br /> __--��%��.�, <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �O w <br /> � <br /> 1 here6y ceRily that 1 have read and exarnined Ihis applicafion and know the same fo be true and <br /> correcL All provisions o/laws and ordinances goveming lhis type ol a ork will be comp/efed <br /> �vhetherspecified heroin ornot The gran7ing o/a pemiif does nof presume lo give authonty fo PERMIT# <br /> violafe orcancel fhe provisions o/any othersfafe orlocallaw regulating construcfion or the r I � � O ' 0 � � <br /> perlomrance o!consWcfion. That I am authonzed by the owoer o/fhis property fo perfomi fhe C <br /> �voik lor�vhich application is made and 1 comply wifh the Sta(e Contracfors law 18.27 RCW and <br /> 296.200 WAC. <br /> ,�_._ /0�l,G't� <br /> Signature Date <br /> FEVIcF008^5:911 <br />