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------- .--� - -- <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STR[ET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org <br />7// � ,��� /� ��'a./L�T,-- ��"�D.� <br />PROJECT ADDRESS <br />Tenanl <br />onlraclor <br />�cense Number (reqwred) <br />Mail Address <br />Idali �ddress <br />Pdad Address <br />�/�.`�'���� �j,��r�,�� _I!0��� <br />Proposed us"� e�i�a�ng <br />Squar� taqe f residenlial new consiruc�ion, remodel or adddion) <br />Number ol dr,vices �II low vnll:ige) <br />Ci�y <br />C�ty <br />Gty <br />���y.�'� <br />, � <br />Stale2p Phone <br />Snlc�Lip <br />S�atelLp <br />Phone <br />Phone <br />Cdy of f:vereU E3usiness I_icense Number (reqmred) <br />_ A/� 2Q(� .--- - - <br />Conlract Pnce of `NorY. <br />� R����✓/ <br />Co itact Perso ICon�acl NumbedCmatl <br />�}��5� �l�f��`9l�%� <br />Description of Work �n �c �one �/V,l]-���r,�n /' 0� lJ�y-vi--f. ��(����- ��-�-- -- -- <br />i [[— — — — — <br />CITY OF EVERETT LOCAL SnL[S TAX CODE IS 3105 /� �� <br />.�' <br />I I7CfC�)y f.C'/GIy (IIfII I IIIVL' Il:i1ll dfl(I CNdf11111CU IIIIS J�(JIICJIIOfI Jqli A110W iI1C Si1pIC lo bc In�r, ond _ . _.. __ .— <br />coirecf. AN piovrsinns olla�vs nnd orJmances ynvenunq (lus 1}�pe o! �vodt �wll he eornpleted --- --- — -- <br />r:he(hr.r speci6ed hcicin or nnf The gr:�nlutq ol a pr.nnd t/ocs nof presurne lo give aufhnnly lu PFRMITN � <br />wulydr.� or r:anccl Ihe provisions ol any other sfaln or loc.�l la�v regufalinry conshur.fron or fhr r <br />pc��omrancn o/%onsfrucfion Thaf I nrn nuthon�ed by Oir. mvnc� nllhis property fo perlonn fhc � ��� �_� a//� <br />�•:ork /or whir.lr ap/1�rryfion is nradc and I cornply �vdh fhc Sl�dr, Conlror.fors Law 78 '17 RCW ,�nd ._. _ J .� <br />296 200 WAC � <br />- -- '-- "-� �___G' '"'�� ���/�---.. . . -- - <br />Sign;dmc " flale <br />�n vr.r r, nam., ;�n u <br />