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� --- -- ---_. - - - - - -- ----- --____ __ <br /> I ELECTRICAL PERMIT APPLICkTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR S7REET, [VERETT, V'JA 98201 <br /> 425-257-881 G - FAX 425-257-8857 -�vww everettwa org <br /> /G24 BAKt�� Av� <br /> PROJECT ADDRESS I <br /> ���N�SS� �o�x �� Ly�Nw�> w.�- 9b oa� <br /> Uwner Ma�IACOress C�ty StatelZip Phone <br /> Tenant tdaJAddiess Cay Slate/Zip Phcne <br /> f,�/t,�lv63Lk S �GlL?Q/G /�� <br /> ElectricalContraclor hAadAddress Giy SiateiZ�p Pnone <br /> � <br /> i l��a,�w� r9�{o�� �l�° -- <br /> Slale License Number Conlract Price o1 Work <br /> SF� ��Ea G��2iE � ae <br /> Pwposed Use o�Building Conlact Person (Plan Heview) <br /> p,�.vc �e.d�-d <br /> S.�uare Foo6�.ge(If residenlial new construclion,remodcl or addition) <br /> Number of devices (Illow vol�age) <br /> Oescriplion ol Work to Ue Done �!��� �'��� �'�'�`�" � �����A5 NEI��s� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 -�S 6 a <br /> I hereby certdy fhat I havo�ead nnd exemined lhis applic�tion and Hnow(he same to be hue and __. <br /> correcf. All provisions ollaws and nrd�nances goveminglhrs type ulwork will6e complefed — <br /> whefherspecilicd herein ornof. The granfing ol a pemiif Aoes nof p�esume to give aufhonty fo pERMIT# <br /> violafe or cancel fhe provisions ol any other sfa�e or local la•�v regulating consln�clion or fhe r, •I/�O � _ DO, L <br /> +erlorm.nre o/constn�cfion. Thaf 1 am nufhonzed by Ihe ownerol fhis property fo peAorm fhe [�/ "' <br /> Nork/or which applicafion is made and I compty�vrth fhe Sfate Confiaclo�s Law 18.27 RCW and <br /> 296?00 WAC. <br /> � ` <br /> . gnalure ate <br />