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- ----� - --. <br />_—� ------ <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREEl�, EVERETT, WA 98201 <br />425-257-8610 - FAX 425-257-8857 — www everettwa org <br />�a r � ���,z�,,� P� � � <br />PROJECT ADDRESS <br />Ci-����i�,tlE �2�� Br�v�=acy �3cv� ��/F,PG�"'T a�,9 �1v�)��4_ <br />Owner L1aJ Adaress Gly SlaterZip Phone <br />7enant <br />//✓-HousE �L� <br />htall Atld�ess <br />[IeclncalContractor rdadAtldress <br />/�yo�•cs �is2 aG <br />Slale license Number <br />��I � <br />Froposed Use ol �uildmg <br />City <br />L�s%�� 5 �v <br />Cdy <br />StaterLp <br />Stare/Lo <br />z <br />PhOnC <br />���f yz� 23y-o �3 <br />�h��,� <br />'�3,00v <br />Contract Price of Work <br />Contact Person (Plan Revie�v� <br />Square Foolage (II residential new construcuon, remodel or adduion) <br />Number ol dCvices (II lor� vollagC) <br />Description ol Work to He Donc. � lQ'i1�iR /�-f✓ �i ?�i/2 L�! C t2 �l'�'Ll7��C. _ _ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 he�eLy ceiLly fh��f 1 have read and exanrined (his applicahon and Xnow fhe sarne fo be frue and <br />rorrecf All provisions o/ laws anU oN�nances 9oveming fhrs (ype ol ivork �vrll be completed <br />�vhclher specified herem or nol The granfing ol a pemrit does nof prr.sume to givc aulhoiity to <br />violale orcancel fhe pravis�ons o/ any ofher sfafe or local law m,gulahng consfruc(ion o� fhe <br />perlorrnance o/consWction. lhaf I arn au�bonzed 6y the o�aner ol Uris propeRy (o perlomr fhe <br />�:�o�k lor wluch appGc�6on �s made and I comply �vilh !he Sfate Confraclors La�v 78.27 RCW and <br />296 200 WAC <br />i vE�-,«o��,� <br />FEE ---- -- <br />—][' Ul� <br />lJ <br />PERMIT� <br />E 130� - ( 22 <br />