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-------------- -----•--- - — --- �— ------— <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982Q1 <br /> 425-257-8810 - FAX 425-257-8857 -www everettwa org <br /> [_,• �yp�—lNS <br /> Cj .. 3 5�l <br /> 4 G — I } o ��1 � V . ���e�✓� � (�cJeie-l-�t I <br /> PROJECT ADDRESS <br /> �oe �.t G-�crL-1'k <br /> Ov+ner MailACtlress Cdy J StaleZp Phone <br /> � � — II . i <br /> Tenanl ydailAdaress c�ry StatMLp pnone <br /> I <br /> e„r� .ya L. L�/ec-+ nr <br /> Electnw Conlractor PAaAAEdiesz C�ty State2�p Phone i <br /> Slate Ucense Number (reqwred) Cdy of Fverett 8usiness license Number(requued) <br /> _�'�V�S�-. <br /> , Pioposed Use of Bwlding Cenlract Pnce ol Work <br /> I h�... S���..��., yas � 6 �-� 7i8 <br /> I <br /> ' Squa�e Footage (II residen6ai new construchon, remodet or addilion) Contact Person/Contacl NumbedEmad <br /> Num6er ol de�ices(II low voltage) <br /> Descriplion ol Work to De Done �i. 5 �-c,.( ( NC�...J �� � �ao�'✓/ Pc�n�Ly_y S K v� I <br /> K F/�t�-�SQ_LFowv c� 1� S- ---- ----- --. _._ _ <br /> FE[ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 �Q� � <br /> I hereby ceiir/y Ihaf I have read and examined this app6cahon anAAnow 1he same(o be frue and .D_____ <br /> correcf All provrsions o/laws and ordmances govemm9 fhrs typo ol work�vdl be complefed <br /> whefher specdied herein or not The g�anfmg al a pemu(docs nol presunre fo give aufAonty to PERMIT# <br /> vwlate or canr.el fhe proviswns ol any other slafe or locall�w regulafrny consWd�on or the ^ � . /O^ _ '�� <br /> perlormance ol consfmcl�on Tfiaf 1 am au(honaed by the owner ol fhrs pwperty(o perionn fhe t (1� "J <br /> work!or whrch applicaGon is made and I comply wrth fhe Slafe Confracfors Law 1 B27 RCW and � � <br /> 296 200 WAC <br /> �ti `ffas iy <br /> S�gnatu Date <br /> LFEV�SEDo6CN10N <br />