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� • <br /> EL�C�RICAL PERMIT �P�Y�n�A`�9��1 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAtZ STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everetlwa.org <br /> ��� c�' so�w� � C( l� f T C <br /> PROJECTADDRESS <br /> �tn Cr � � �� / <br /> Owne� il Address City Slate2ip Phone <br /> Tenanf MailAddress Cily SlatelZip Phone <br /> ��v-� ���1', 7�l �5��..s�� �,C(� s�tih�a�1�.��'zi� <br /> Electrical Contr3Clof Mail Address Cily SlalelZip Phone <br /> � 1-a�-�CZd�9,� j �S a�i _ � <br /> Sla�e License Number Conlrac rite ol Work <br /> ��C' s ' �_ <br /> Proposed Use of Building Contact Person (Plan Rei�iew) <br /> S��O� <br /> Square Footage(If reside�I' new consiruclion, remodel or addition) <br /> Number of devices (II low voltage) ^ <br /> Descriplion of Work to Be Done: W 1 'r�'-• ' " rw � ��� <br /> -- p P S Pvvyc <br /> — v i�i e �� ✓� ��� � /oD /�� �� � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 y � �,�� <br /> U" <br /> 1 hereby ceRily fhat 1 Aave read and ezam;ned lhis applica�ion and know(he same fo be(rue and <br /> correcL All provisions o/laws and oidinances goveming Ihis type of work will be completed <br /> whefhers cilied herein ornot. The granfing ol a pe�ni(does nof presume to give authorify(o PERMIT# <br /> violate rcan ellheprovisionsofanyo sfafeorlocallawregulalingconstructionorfhe r � , j� / — ��V <br /> peAo mance o constn�c(ron. That 1 a hunied by fhe owner o(Ihis propeRy fo peAomr fhe C (.r' (Q O <br /> wor lor which appli fion i m de omply wilh the Sfa(e Confrac�ors Law 13.27 RCW and <br /> 29 200 WAC <br /> � ��/ <br /> Signature� Dale <br />