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�-- —-- <br /> � <br /> ELECTRICAL PERMIT APPLICATION <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�-9- ��( <br /> �Za /-J� �Er.so�v ��� � <br /> PROJECT ADDRESS <br /> �oo�� ir,uEfz. sAM�- �s A�✓E �o zo I yz.�3z2-S�53 <br /> Owner Ma�lACdress Gty Slate/Z�p Phone <br /> Tenanl Mad Address City S�a�e2ip P�ona <br /> Gl�s 23� <br /> �✓i/2ciNor��<SFczz�i�,�r'c /y�2r 2=°�v�Nw �a2ys✓���r�wc� 98z�1 0� <br /> Eleclrical Con�ractor Mail Addiess Cdy State2p Phone <br /> i,v r iz� w E x 9 �l o c, 7 o yySG� <br /> State License Number(reqwred) Cdy ol Everetf Business License Number(required) <br /> .��j O.p o�' <br /> LANnsc�n� wi�i,�C -- <br /> Proposed Use ol Buildmg Conlract Pnce ol'Nork <br /> �2� CuRR/� �fZ�' Z�$ -a/� <br /> Squaie Footage(H residential new cons�ructwn, remodel or add�tion) CoMact Person/Contact NumbedEmad <br /> f2�Jm cu nn i�@,7v�.io,c o r+. <br /> Number of devices(If low voltage) <br /> Descriplion ol Wo�k lo Be Dona 7r/✓o G�2Gvi '/� f"o It LA�N nSGf�-/'G'- LIGNTJNr __ <br /> FE[ +\ -- <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 �O VU <br /> 1 hereby certily Ibaf f heve rcad and examined fhis applicatmn and know the snmc ro bc 6ue and <br /> conecf. All provis�ons olla�v�and ordmances govemrng fb�s lype ol work wdl be r,omp/eled — <br /> whefher speafied herein or nof. The grantmg ol a pemid does nof presume to givc author,ty fo PERMITII <br /> v�olale or cancel7he provisions ol any ofher sfate or local law regulnfing consfruction or fhe � I � ^�` / O� (-� <br /> pedomiance ol consfrucfion That I am authonred by fhe owner o/fhis p�operty to peAonn(he (J�"I l/ <br /> work lor which app6cafion rs maAe and I comply wdh fhe Sfate Conbaclors Law 78 27 RCW and <br /> 296 200 C <br /> ✓� ��e 5�� �iy <br /> Signalure Dal�- <br /> PEVISE00l�96R01� <br />