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- - -- � - - - • - <br /> ' ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> ' 3200 CEDAR STREET EVERETT WA 98201 <br /> 425-257-b810 - FAX 425-257-8857 —www everettwa.org <br /> Clyll-�OZ I <br /> 1 <br /> , i�_3 ���{ � <br /> , ��� � W C.O�S i n D Rc) �veYe-1�� Y���1,0� <br /> ' PROJECT A�DRESS <br /> ' �nvn� Ener�u ��2a i C�S�r o � �ne�r �vA �2fl`-I c125 -�'3-� 3 <br /> I Own. Ida�l ntlA•rss C�ly SIatC�1�p Phonr <br /> � C����.-ro�.�-e�,h�ro I c�► e� '1305 S�ix, [�,n o A've �fi 33� l.G��d n, TX �8�-�5 i <br /> I ien:fnl :ad nea�rst C�y �Ixr Lp VP^rr � <br /> � ��c.h�rG�r �nc � �Z� (�vr�rc,� �e N Cec��f�te wr1 ��I33 20��3��-���oa <br /> � ElecVicalConir�ctoi va�tiaarrss C�iy s�av�Jip Prone <br /> � <br /> fAUi"�-�-� O�B lS ' Iq��S �, <br /> � Slale I.icenye VumOer��rquued� Gty ol lve.�etl Bus.ness L�cense Number(requ�red) !i <br /> ! ir�sta i � Se,cnxm� dcv��es Lt�� vo��a�ate) �, �o ' <br /> ��� Pioposcd Use ol �u Id�g CoMract Pnrc ol Work <br /> ' �o odo Wbcr� ��ra.hou n 2a�-��3- , � <br /> 'I Sauare�-ootage Q'resitlential new consirucl�on remodel or addit o�l CoNar.t Pe�soMContact NumberlEmail <br /> II _ �- <br /> �, Num�er ol aevices 01 low vnllagel <br /> �', Descriplio�ol Nbrk lo Rc Donp (�S�V l ��_��,� (it'�.� lX J' � w' "� � '����.]_� �^' �-`�t��ti1� <br /> g e.r�.r sInQY re-rea�es,lt? dbur t-hor NvrtCh.ps, v�rcttss �i, <br /> I' , 0�1 ��5oT5°I3��u� ss _n�Yo� wp�.11 �Fte�d e,nUod'�,+-t s il <br /> I " FEE I <br /> CITY OF EVERETT LOCAL SALES TA% CODE IS ]105 �U� <br /> 1 hereby cerbly fhal l havc rcad anA eaarnmcA�his appOcahnn nn�Mno�a fhe same fo ba frue and I <br /> � corrrcl All prov�s�ons ol laws anA ord�nancrs qnve.nm�tlus tyPP nl wrnF wJl he�ornplefed <br /> wheflrer spcuhed herrm o�nnf I he granGny ol a permd Aocs nof presume fo grve aufhnnty(o PERMITJt <br /> violafe o�cancrl Ihe provnwns of any olher sfafe oi local Inw regulalrng wnshucl�on nrlhe � I �I I D/� � <br /> peAo�ma�ce ol consf�ucf�on Thal 1�m aulhonmA Ay P�e owner ol Ih�s p�operty fo pe�fnrrn fhr lJ <br /> ! worF Inr which appl�cahun is maAa anA I comply wrfh fhn Sfafe Confracfois Law fA77 RCW and I <br /> i796. . O WAC <br /> � l 0/�g ( <br /> IIlgnnWrc �VA�� <br /> � Fl� S�l� 9 n. i'1 <br /> � _ _ _ __ _ .___ . <br />