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— — -- -- - — — - - — __-- - - - — --- - � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVER[TT, �VA 98201 (,� `-�t� ..11� <br /> 425-257-8810 - FAX 425-257-8857 —tnnvw.everelivaa.org (q � <br /> G �� °y ` <br /> �.�a G�ri`d�ew�/ �v�e�e�tfi ��2 0 � <br /> PROJECT ADDRESS � ,l z S 2�jJ' �0 � � <br /> 5�v-N- t'�'Ca�! � wush n� s w ,�w k-f� �eo ,,��-y�z�s _ � <br /> Owner MailACdress City Slate/Zip Phone <br /> Tenanl MailAddress Ciry Slate2ip Phone <br /> (j v'Y1-Q� ��n�2 � S alzlr-C_ <br /> Eleclrical CoMractor MailAddress Cily State2ip Phone <br /> Slale License Number Contracl Price of Work <br /> IZ��-t-� ( N d�� <br /> Proposed Use of Building Contacl Person (Plan Reviev�) <br /> Square Foolaye Qf residential ne�v consiruclion,remodel or addition) <br /> Numbe;of devices (If low voltage) <br /> Description o(Work to Oe Done: �_��_C,@y�(� V C��S � M 2 /U �� I /O <br /> _� � 2r�o �� 1�� �.el <br /> ree � 00 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �f � <br /> ! <br /> 1 hereby certily tlrat I have read and examined(his applir.afion and knor�(he same!o be frue and <br /> conect. ,9q provisions olL��vs and oidinnnces goveming fhis(ype ol work will Ge r.omplcled <br /> whefhcrspeci�ed herein ornoL The granling o(a pemiil does nof pmsorne!o give aulAorify to P[RMITt! <br /> violale or cancM fhe provisions o/any ofher sfate arlocallaw regu/afiny conslruclion oNhe � <br /> performance ol conslrucfion. Thal 1 mn aulho�ized by(he o��merol this propedy fo peAorm Ure I �Q�— I � 3 <br /> v✓oric Ior whi applicafion is made and 1 comply with the Slafe Conliacbrs Law 1 B.?.7 RCW and <br /> 29G.200 W <br /> ' Signa re - ---- �� v' U��L� <br />