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�_ — — <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CECAR STREET. EVERETT, WA 98201 �5�� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org �?� ,���.�56 <br /> � /�`�� ����.?w�� ����-� �.✓�� y$�o/ <br /> , <br /> PROJECTADDRESS <br /> ����L.L�,,�f��� ���..�1 Y�z76� <br /> �« ' l��1/S �5�/��O���i�i� e l � �(/ <br /> Owner <br /> ' Mail Address Cdy Slate2ip Phone <br /> � Pho e <br /> Tenant Mail Address CIry State/Zip ��� ��• ��/� <br /> //t��r+�ha'L,�,s -�'hG �J���GF,�.r.�l ���e�i���'y��%�4�1�7 i��C(ek�L�R� 9`��12 <br /> TT� ' MailAddress Ciry Statel ip Phone <br /> Electrical Contraclor <br /> �!L'H.11-LL� ������ Contrect Pr ce of Work <br /> State License Number <br /> , <br /> �x� � �`/� Conlact Person (Plan Rev:ew) <br /> Propose s f Building <br /> Square Footage Qf residenlial new construclion,remodel or addilion) <br /> Number of devices(I(low voltage) <br /> I Description oi Work to Be Done: /7LYQ��/f'� � �" v ��H D�/I�Gk <br /> I <br /> FEE <br /> iCITY OF EVERETT LOCAL SALES TAX CODE IS 3105 5�!•ClD <br /> 1 hereby certily fhat I have read and examined fhis app/ication and know the same to be trtie and <br /> Iconecf. All prvvisions olla�vs and ordinunces goveming fhis type o/�rork�vill be completed <br /> I �vhether specilied he�cin or nof. The granling uI a pemiit does not presume fo give aufhonty to PERMIT# <br /> violate or cancel the provisions o/any ofher state or local!aw regulating consWcfio.a or fhe r ��)� _ ^�.� <br /> perfonnance of consWcfion. That 1 am 2uthonzed by the o�vnero(fhis propeRy fo perfomi fhe C �K- <br /> �vork for�vhich applicafion is made and 1 comply with Ihe State Confractors Law 18.27 RCW and <br /> 246.200 WAC. <br /> � �,/�/d <br /> SignaWre Da1e <br /> I <br /> :;,r,��:�:�.,:;i� — �i <br />