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EL�CTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEkETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> ��.1_��.^,�:..�-1 <br /> c <br /> PROJECT ADDRESS <br /> c��„�4 �'-�1�n�1- S4nn� !�s _1�F'7c�-%� <br /> Owner MailAddress Ciry Stafe2ip Phone <br /> Tenant MailAddress City StatelZip Phone <br /> � � F-c��oaL.,��C F�-�u����lr�n�l�.i�u�- uA-�f3Z� ��c9�lyS�i � <br /> ElectricalContractor MailAddress Cily Stale/Zip Phone <br /> � �-,-��-�� ��d��- �,- ��� -- <br /> Sla�e License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � 2 0�� <br /> Square Footaye Qf residential new consiruclion, remodel or addilion) <br /> Number of devices(If low vollage) <br /> Description of Work lo Be Done: ��- ��LF' ��Ct�T�G�- � � S"1 5�'1�� <br /> �J d� Cw �7 c � 1 s� � �ti -1—�•� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �� C�O I <br /> 1 hereby certi/y(haf 1 have read and examined fhis applicafion and kno�v the sarne to be frue and <br /> correct. All provisions o(Imvs and ordinances governinc�this type o!a;ork�vill be completed <br /> whetherspeci(ed hcroin ornoL The granting o/a pemiit does not p�esume(o give authonty to PERMiT� <br /> violate orcancel the provisions oI any otherstate or/ocallaw regulafing cons6uction orfhe �. <br /> peAomiance o/consWctiai. l hat 1 am aulhoiized by the o�vnero/Ihis propeMy to pedomi the E I ��O � — I S(� <br /> work lor which application is made and f comply�vith fhe Sfate Confroctors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ZS <br /> Si n�lure D le <br /> r,ec�em�.�su ___' <br />