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� • <br /> E�ECTRICAL PERMIT APPLICA°TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEOAR STREET, EVERETT, WA 58201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> v�l� � , ��r ol'Gva i �{l�l i� ,¢ <br /> PROJECTADDRESS <br /> �n �� r� �� � <br /> Owne� il Address Ciry Slate/Zip Phone <br /> Tenanl �.taitAdtlress Cily Slate/Zip Pi�one � <br /> Cl-�„--�-s �/��, 7�� as��.�� d�,�� S'��������'z�� <br /> Eledrical Conlracbr t�la�l Address Ciry State2ip Phone <br /> � ��-�-�za39� 9 �sa�v _� <br /> Stale License Number CoNrac rice o1 Work <br /> (� � S • �— <br /> Proposed Use of Building Contact Person (Plan Review) <br /> S oo� <br /> Square Footage Qf residen ' new conslruclion, remodel or addilion) <br /> Number of devices(If low voltage) /� <br /> �escriplion a(Work �o Be Done:�-W�-�� f�-- ' " r� � �` e� ` � <br /> — �O� �►�P l�c� �Pa{' s �v�v✓cC - — <br /> — � ��i e�� s ���c �c- /oD �� ��� <br /> FEE <br /> a� � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 D <br /> I here6y ceRify fhaf 1 have�ead and examined this application and know Ihe same(o be true and <br /> correct. All provisions ollaws and ordinances goveming fhis type ol work will be complefed <br /> whether s cilied herein or not The granting ol a permit does not presume(o qive au�honty fo pERMITil <br /> violate rcan el(he provisions ol any o s(aJe oriocallawregulating consfiuction orthe ^ ' �O/ ✓ O �� <br /> peAo mance construction. That I a honied by fhe owner ol(his property fo perform fhe t b <br /> wo /orwhich appli fion i m de omply wilh the Sfale Conlrac(ors Law 1827 RCW and <br /> 29 200 WAC <br /> � ��j . <br /> Signature � Dale <br />