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_ _ _ _ i <br /> � <br /> _ _ _ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> ' 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 4�5-257-8857 - www.everettwa.org <br /> � i�YY�/t'�"Dy <br /> I u,�f-7 r�*�►' <br /> '� �vda-7 ��`l ca `�� �� f�" <br /> PROJECT ADDRESS � ���9 /I <br /> i �,cc.l�ar� f�,nr���e� �� I(Ry �ynnc�' w� �`S `� � ���— � <br /> � OWner M1la��Mdress Ca� SIa1MLp Plmne <br /> i <br /> lenanl 1da,�Aecress Gtr S�ate2p Phone � <br /> � 1 � C) ,,�� ' f � G Cl�p. ��S- i <br /> � �77t�CP� W.eL ��L ��� ��w ,� ��P T1 �c � 8'7/0-7 4�� <br /> IElar,tnr,al Coniraetor r.�ad aae��ss T� Gp Stai��Z�p Pnone � � <br /> I S�-eelec.-�,��Dr� <br /> �I State L�cense Number�1eqw/etl� �y of Eve�ell Business License Number�requ�red) <br /> Rerr�� � ��r�'� <br /> �i ProposcA Use o�f3uddmg Conlrecl P��r.e of Wn�k � g ; <br /> y��-s6�4�- 4 � <br /> , ��j 7Y��rS �ee�e t�pv,s�vs1�(QCL, <br /> � SQuare Foolage(If resitlenlial new conslruclwn �r,model or aAAi�iorl Contact Person Conlact Numbei'Ema�l <br /> � <br /> � <br /> I _ � <br /> � Number ol devices(II low voltaye I ^ � <br /> IDesr.iiption ol Work to Be Done� ` e\ I��e �"���� �4 ' �C�y��\ � �CJ� <br /> � �- C�� 1 l 1�.��s, <br /> I FEE � <br /> CITY OF EVERETT LOCAI SALES TAX COOE IS�105 �Cj ��- <br /> 1 he�eby certdy�hat I have�r.ad an1 eram�nedlhis apphcahon and know fhr. same fo De Vue and <br /> conecL All provisi�ns nl laws and ordinances gnvernmg flus fyPe ol work will be cumplefed <br /> I whefher speciGed herom or nof. The yranGng ol n permif does nol p�r.sume to grvr. aulhonty fo PERMITif <br /> � violafe or cancel the provrsions n�any othm sfale or local law regula6ng cunsVucbon oi Ihe E �y��_.��� <br /> ' peAormance o/r.onstn¢fion Tha(1 am aufhorizeA Gy fhe owne�ol(his propehy fn pe�fnrm fhr. <br /> �I work lo�which ApplrcaGon is maAe end I .omp�y wdh(he Sfale Confracfo�s Lnw iB 77 RCW and <br /> �, 296 700 WAC <br /> , C� -- ' �l-l�-� --- <br /> � Si aiure DA�P <br /> ` <br /> 4i 4�r�f(���{.M]_�l1 <br />