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ELECTRICAL PERMIT APPLICATlON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, L=VERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — wwve.everettwa org a -�-4�-/� <br /> �I'�o� -141 <br /> �� 31�1s�G�A�L L;UL'2� i i� �.t�Gj- ctPZt(9 <br /> PROJECTADDRESS <br /> S��} (�/�c ��s �r3vvc�) <br /> Owner MailAddress City Slate/Zip Phone <br /> �SOv✓�b� l9S �0✓G�� <br /> TOnant Ma�lAddress Ciry Stat^2ip Phone <br /> CTI:RL�_NiL=LL-�-�Cst�C..�rT• ��3o i���Tt9 ST Su1 Wv,.x�o�y wv- �J��_ <br /> ElectricalContrador ldallAddress City Slate2ip Phone <br /> �'rt'�LL�C-�1�SL �So o .�� <br /> Slafe License Number Conlracl Price o(Work <br /> C.oWw��ytZC I Lb L itl�(1- <br /> Proposed Use of�uilding Contacl Person (Plan Review) <br /> N h <br /> Square Pootage Qf resideMial new cons�ruclion, remodel or addilion) <br /> ��1a_ <br /> IJumber of devices Qf low vollage) I <br /> Description ol Work to Be Done: _�Q ��> >�Z ?� �L��Ll.�S P Z l��S�li'�� <br /> C�{ 1-� ' --— <br /> F[E <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 � '] � /� <br /> � v <br /> 1 hereby certily fhaf I have read and examined fhis applicafion and know Ihe same!o be 1roe and <br /> wrmct. All provisions ollaws and ordinances goveming lhis type o!worN�vill be completed <br /> whether spccilied hemin ornoL The qran(ing ol a pemiif does nol presumc fo give aidhonty(o PERM]T# <br /> violafe or cancel the provisions ol any olher s1ale or local law regulafin,y cons�ruction or Ihe � <br /> pe�formance ol consfruc(ion. Thaf 1 am aidhonzed by fhe owncr ollhis p�ope�fy 7o perform fhe / / <br /> work lor which appirca(ion is made and 1 comply wilh(he Slate Conlraclors Law 18 27 RCW and � � � � ( �I T <br /> 296 200 WAC. <br /> Signature Dale <br /> n�vrru�mn <br />