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� <br />� <br />ELECTRICAL PERMIT �4PPLICATIOIV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�/�i� �'� ► /a+�� v�r��� <br />PROJECT ADDRESS <br />%�(.�,Q/= N� I,�� . F� i tZ@:�F �n� ✓et�►�►�� ►� L�J�s%. 3db -y28�'�I�-19`7 <br />Ownef Mail Address City State/Zip Phone <br />�i' P� .�r�°} f� ��9 9 q'� S7 �ver��t k�ce��a �-�6 -Zz6 �6�y 1 <br />Tenant Mail Address City State/Zip Phone <br />�-r2�1�x►� t" �/� i�-fi"-e t-- <br />� r�-�1��►� � 9 �� �vea� � c�� 2 �b z�6 �b.�-�1 <br />ElectfiCal Contractof Mail Address City State/Zip Phone <br />State License Number <br />� �� �� �e� <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />�+ _ <br />�' ,, '/",', <br />CITY OF EV <br />I hereby cer , <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified he�ein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other stafe or /ocal law regulating construction or the <br />performance of construction. That l am authorized by the owner of this property to perform fhe <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WA�. � , <br />� <br />L i� OC)`' �' <br />Contract Price of Work <br />Contact Person (Plan Review) <br />[J <br />Signajure <br />O�I2�I ZQ� <br />Date <br />PERMIT# <br />E�►`�� >>-U�-� <br />