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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EV�RETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WP. 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.gov 7`� b_� s <br /> [_ � so6 — I `� l <br /> -/ I '� /' ,�Y���'-�,-- <br /> —r�--�—� <br /> PROJECTADDRESS <br /> �1 �r�% I �,32 ��C����._. cl%,s-.� /� y�l�� <br /> Owner ldail Addmss City Slatc2p Phone <br /> �� �� �( !� l /j <br /> Tenant tdail Address City Slate2p P�one <br /> `��77�0 <br /> ,�ti �i>,� �Si,��� - ��iva�tr�r�.- r�� -�j�c� a�s-- <br /> cletiric I Cont Ctor IJall Address CAy SlalelZip Phone <br /> � i�evlM 5 S�S'�l7 �����sia <br /> S�ate Licen Number(required) City of Everetl Business License Number(required) <br /> l _�1/1 I'11 ��U L ci� `�/D� — <br /> Proposed Use of Building Con�ract Price of Work <br /> �G{.f i'-G,c�/�l� <br /> Square Feotage pf residential new construction, remodel ar addition) Contact Ferson/Contacl NumberlEmail <br /> �'�C��s� ��Js�,�sys�`�s� 7 <br /> Number ol devices (If low vollage) <br /> Descriplion of Work lo Be Done: <br /> 1�''��/' �� l.�-Cr'`�1�.��� lR�� v�9��� <br /> FEE <br /> CITt'OF EVERETT LOCAL SALES TAX CODE IS 3105 �/� Y3� <br /> I hereby certAy thaf I have read and examined fhis application and kno�v the same;o be true and C/ <br /> con�ect. All provrsions o(larvs and ord�nances goveming fhis type ol work wil!be complefed <br /> whe(her specilied herein or no[ The grenfing ol a permrt does not presume to give authonty ro PERMIT# <br /> violafe or cancel the provisions o/any ofher.stafe or local law regulaGng consfruction or fhe � ��O� Ip�/ <br /> performance ol consfrucfion. Thaf 1 a a'Gthonzed by Ihe o�vner ol this property to peAorm fhe � 0 Q <br /> ivork(or i i application is made d 1 comply with fhe Sfate Confracfors La�v 78.27 RCW and <br /> 296.200 A <br /> �� � z - <br /> � iS <br /> 'ignalure ate <br /> REVISCD CBiDEG01. <br />