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_--_ ____— _ — --- <br /> � <br /> � ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8610 - FAX 425-257-8857 —www.everettwa.org <br /> � `-t'�� ��A �W �� <br /> PROJECT ADDRESS <br /> �fl� � DfzNE �'N Iyo , f�eoA/��,-��-; ��fd�� �3z� � '-�- � � �J <br /> Owner MailAddress City State2ip Phonc <br /> Tenant MailAtldress City Stale2ip Phone <br /> KeRss , r� ���rc.fa-� � Pv �vx�� �'s���1f �8?aC� `�zs-� / <br /> [IedricalCoNractor MailAddress City Slate/Zip Phone <br /> K r�����c.,�7PG- 05'01 L �^ <br /> State License Number(required) City of Everelt Business License Number(required) <br /> ��S t ��'_� I <br /> Proposed Use of Building Conlracl Price of Work <br /> t <br /> Square Footage(If residential new conslruclion, remodel or addilion) Conlacl PersonlContatt Number/Email <br /> Number of devices(If low vollage) <br /> Descnption of Work lo�e Done: ��T('� �-C--- T" SI�O �� ������-� <br /> �_.��PA� � (�2 � ��Ti ot� �E���'i aN S ����� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � /�� <br /> (J <br /> I hereby ceriify that 1 have read and examined Ihis applicafion and know fhe same to be tiue and <br /> cnrmcf. �II pruvisions ullaws and ordinances goveming Ihis fype o/work�vill be completed <br /> �vhefherspecified he�ein ornoL The graating oI a permif does nof presume fo give au(honly fo PERMIT# <br /> violate orcancel the provisions of any ofhersta(e orlocal law mgulafing consWcfion or(he f <br /> perlormance olcons(ruction. That 1 am authonzed by fhe mvnero(this property fo peAomi the t � � � Z '� I�� <br /> �vork forwhiclr applica!ion is made�nd 1 comply wilh fhe S(ate Contracfors Law 1827 RCW and <br /> 296.200 WAC. <br /> � � �a �/��� <br /> Signalure Date � <br /> aewseooavs2ma <br />