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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257•8810 - FAX 425-257-8857 —www everettwa org <br /> I <br /> /��/�riho/��', s ���P � <br /> PROJECT ADDRESS �;I <br /> Ov/nef �—� �da�l Ilddress C�ly — - �--State2�p ---—J��'�one <br /> ������t-- 'L ,�1�1r�4/��!f(t,�pp ,�iP/�W�� _r �D`d - <br /> Tenant IdaitAddress Cdy —� P�UIeZp Ph�o e <br /> �, M7IIG� K n Y�J�T?'�jJ'✓� � <br /> /� � ' L C /33�r��/�,�!(/"�/Cl�-l�✓�; �' 303ri1���� U/�l�l` <br /> Elettrltal Con�raclor Mail Address Ciry Slate�Zip Phone I <br /> 1 <br /> i/�i�i�� j���'�/c ������ __ � <br /> Stale License Numbei(reqwred) City ot [verell�usmess License Number�requ�red) <br /> r �'f ��1./„nl.���/�.y►� j'�� --�-L�--- --- <br /> ProposeA se ol�utldmg Cordract Pnca ol Work <br /> I �� , yz.y�� -Z � 1 <br /> ; Squaie Foolage Of residem�al new constructwn, remodel or addiUon) Con act I'eisonlConlact NumbedEmail <br /> I <br /> I <br /> Number ol devices QI iow vullagc) <br /> i <br /> � �J r J� � ��j <br /> Duscriphon ol Work to �e Done� �� �'Y�'✓�D��Y�����_����"� �-'�'������� � <br /> ---�------- — <br /> - s-��12�h/_�J�pr�---- - — -------- -- --- - <br /> Fee ---G--- -- <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 ��� _l <br /> I he�eGy r,er6ly fliaf 1 have rend anJ examineJ(his applical�on and know fhr, sarnc to iic f�uc and __— <br /> cormcf 1111 provisions o/l�ws and ordinanc�;qnw�nnrg Ihrs typr, ol work�wll be cump/efeA - <br /> �vhether speci�ed he�ein or nof Thc granung o� �pemnf does not presume fo grve authonty fo PERMIT# <br /> v�olafe or cancel fhe provisrons ol any othm sfafe o�loc��l law rrgulafing consfruclion or fhe � I � � O _ I �� <br /> perlonnance ol consWctiorr. ihaf 1 anr aufhonzed 7y fhe ownero!fhis properiy fn pe�fonn the <br /> �vork lor�vhir.h apphcahon is madc nrrA I conrply wih Ihc Sfa(e Contracfors Law 18 27 RCW and _ <br /> 296 200 W�C. <br /> �' /��.2��� <br /> Signalure Uate <br /> Pry��.p(PCfi90:1 -_-_.-___-_-_ -__ _._._ . <br />