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� -- <br /> � — - ' <br /> � --- -- I <br /> ELECTRICAL PERMIT APPLICATION <br /> I CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I 42`i-257-8810 • FAX 425-257-8857 —www everettwa org <br /> `f 30 � C�rsr�o f�oa� <br /> � PROJECi ADDRESS <br /> C�ry s�ate2q Pnonc <br /> ow�er ��+a�i naa«�; <br /> F�'Y}rl't ��t� y7(� !� C.NflnJ �ZwN �.(/��1/ �T df0 Z�ff Lo6 -716 -�S/y '� <br /> � 1.!aA Address Cny SIa1r.IZ V P�wne I <br /> TrnaM <br /> Soun�/ Spcya li eccP Ss✓�/ictS i� � I <br /> !dail Pddrass Gty `1atrQ�O PhOne , <br /> E�eclr�Wl Contractor i <br /> SoundSS 876J 9 45Z3y� 1I <br /> � State L�cense Number Irepwredl C�ry o�Everen 9us�ness L�cense NumSe� (�eQwreh) <br /> �9oa I <br /> Contract Pnc.e of Work '�, <br /> Prcposed Use ot Budding � <br /> i <br /> �� Sq�arc Footaye�II resitlent�al new construq�on, remodel or ad0ition) Contact PersoNl'ontact Number;Ema�l II <br /> � Number of dev�ces pl low voltage) <br /> p 1 / i <br /> ! / ih�•n� /ic7�^ t . <br /> �� Descnption at Work lo Be Done ___� — I <br /> — — I <br /> - — - ! <br /> FEC - _ rn I <br /> �� CITY OF EVERETT LOCAI SAIES TAX CODE IS 3�05 � �� • ' <br /> 1 hcreby ce�hty thaf 1 have read and ernrnmod Ihis aPPl�Cuhon and know fhc same 10 Do frun and --_ _. <br /> . _.—... _ -- � �� <br /> r.oneCt All prowsion5 0!IawS and adm�nces govemmg tlus rype o!work �wll h�complefed <br /> n-hether speal�ad hr.rein or not ihe grent�ng ol.i pr.rmd does nof p�esurne fo y�ve authonty fo P[R�MIT1�D�' ��� � <br /> vinlafe or cancol fhe prov�sions o/any ofhor sfafe n�local law regulaf�ny ronsfrochnn or fhe � � <br /> peAormance o!conshuc6on That I am aulhnnleADy Nie owne�o/fh�s property fo pe�lnrm the <br /> wwN lor w�hich apphca6on�s maJe and I compty wRh Me Sfafe Conhacfors Law 18 27 HCW and <br /> 296 200 WAC �// . /�Cr <br /> � <br /> �' ✓ <br /> � a1C <br /> Si� aWre ' 'i <br /> II <br /> ui� �IJcs;6ar�a . . . . . . _ -_—_� <br /> ___ _--___ .__ . . . "_ <br />