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' —� --�--- - <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98?.01 , <br /> 425-257-8810 - FAX 425-257-8857 — www everettwa.org <br /> `7 _o9—rS <br /> (?�5'0 7—a�{c( <br /> $0 7 W Cas �No R� <br /> PROJECT ADDRESS <br /> Ownr.r MaA ACdress City StaleZp Phone <br /> '1a5 - <br /> �-/I �a yo��l 50 7 W C�s�Ne Q� Ev¢1�tt l�✓�i 9 P"o�OH 3j 3 �.�67 <br /> Tenant PnaJ qtl�rcss Cdy ;taiciLp Phonr <br /> � TE �lrerRie,rne. �3�Y5 �t�o4 Rb 30�/ t�/A 9�a3a �do �5�•�300 <br /> Eleetrmal GonVactor hlad Address Cdy Slate2p �'none <br /> r�o1Ni ES �Y8 J � � l 98 '7 <br /> Stale Licr.nse Num6cr(reqwred) Gty of[verMt Business �ir.ense Number(reqmreA) � <br /> s .�q,� a� <br /> Pro;oseC !�s^e!9wld�ng Conlract Pnce ol Work <br /> Squn�e Foolaqe(II residential new construcl�on, remodel or addihon) Contacl PersonlContacl NumbedFinad <br /> i <br /> Number ol dewces(If low vollagc) � I� <br /> Descripl�on ol Work to Bn Done C/`�` ��' ��' � �v�i ��� i /J U u �!i e� [�/ / 1� <br /> r/ i <br /> 5 � ��� ,.�, � `/ �i< . . � / � �,�, � � -- <br /> r[F <br /> � � <br /> CITY OF EVERFTT LOCAL SALES TAX CODE IS 7105 /^/1 J� <br /> l(/l/ <br /> 1 hereby cerLty fhaf!hFlve reaA and eramrnr.d thr;,ipp6cx6on and know Ihe same fn be hue und _ <br /> correcl AI!provision:o!lnws enAo�Amances governrng Ihis type ol work w�ll be cornU�efrd <br /> whefhe�spen/�ed herem or no� The granhng ol a pcimrf does not piesume lo grve nulhonty lo PERMIT# � � <br /> v�olale or canrel Ihe prov�srons a!eny ofher sfnte nr locul lew reguletrng conshucfron or fhe ^ I �O^ _ O � <br /> perla�mnnce of wn;huclron Thef 1 em oufhaued by fhe owncr o/fhis property fo peAorm fhc t � <br /> work lor which epplitr�fion rs medr. �nA f comply f(h the Sfnfe Confrocfo�s Low iH?7 RCW and �' <br /> ?96 200 WAC �j j <br /> � /�='� / — <br /> � , � /� <br /> SignaWrc - Oat <br /> r+r v¢r o on nn v,�r. <br />