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--- --- -- -- � - -- � <br /> — - - ----- --- - - <br /> , � <br /> I� ELECTRICAL PERMIT APPLICATION ! <br /> CITY OF EVERETT PERMIT SERVICES i <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> ' � _27—/Cf <br /> ;� �I�l/a-i3 9 <br /> j �o� l C� (�d � <br /> PROJECT ADDRES <br /> C�l0..�e�.�.�. �{-�' �UI� �ac� EJe�ii W� qg2o3 �-2S• 783 Ilo1� <br /> IOwner Ma�l ACdress Cny S�a1e/Lip Phone I <br /> i I <br /> � — <br /> ITenanl MaA Address C�ry Slale2lp Phnne <br /> la.ea�a�n 4�2ai`i�.�i z f�m'1�,Gm���b�-ians Po �o�c �98 Mcl�ilsvillf,l��a `)g2�o 3(vo. � <br /> Elecfn I Conlractor Ma�l AdCress Gty IateZp Phone <br /> I i r�RaG 1-it'�8(n3k� _ �'�0�8 <br /> State L�cense Number(repwred) City ol Everett Business License Number(reqwreA) <br /> S F� <br /> Proposed Use of Budding ConVact Pnce of Work <br /> SQuare Footage(II resitlent�al new consWchon, remodel or additwn) Contact PersonlContacl NumbedEmail <br /> Numher of devices(Il low voltage) <br /> Descnp�wn ol Work lo Be Done�. �DDC��lL1 ll�Q �YY�1Q.�°—{'YIOS �.�_���1'L�' !° Q�� <br /> (�1.P ' ' .�u�t�� - � <br /> FEE <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS J105 U� <br /> �O <br /> I horoby cortity fbaf 1 have rcatl and examrned flrrs applrr.ahnn and know fhe samn lo be fruc anA <br /> correcf. All provisions ollaws nnd orAiwncos govemmg Ih�s fypo o!work wdl ba compleled <br /> wheflre�specrfied herein or nof ibe grenfing ol a pa�nif r, res nof prnsume fo givc aufhonty fo PERMITk <br /> v�olafe or cancel flre provrsions ol any ofhw slafe oi locel L�w mgulahng consfrucfion or fhe � � L� �� ' I �� <br /> peAormance o!consfruchoa TAaf I am authoneed by(he�wnar o/this property to peAorm fhe � <br /> wnrk lor whicb applica6on is mede and I comply wilh fhe Slefe Contracfors f aw f B 77 RCW and <br /> 29 00 <br /> �-Sig e ��e�o�l� <br /> aevise�noanvm�. <br />