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r -- <br /> _ _ ---- --- . _ _ _ __ i <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> I CITY OF EVERETT PERMIT SERVICES I <br /> i 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I 425-257-8810 - FAX 425•257-8857 — www everetlwa org i <br /> � <br /> I <br /> � �l�/7 � edq ,� sr <br /> � PROJECT ADDRESS <br /> Ov�2 l ��ei�e��2�_h/�/�- ����,�T�_-1�/i.�_ vas- ��-_k9Y�� <br /> Owner �da�iAdCress C�ty Statr,� Pnone I <br /> � , - I <br /> � Q��s��av.-se,�r,,,T�3�eadri�—_ Po �3�_�ss's CL�c%'a„ 9���5 <br /> � TenBnl �daJAddress C�'r ����� Phune <br /> � ���?tn �X — — — __ _— � <br /> iEI clricalContrador ldanAddress Gly � '�hone <br /> I �— 0� 7 �f5 3 <br /> State License Number (reqwred) Gty of[verett l3usmess License Numbei(required) , <br /> I <br /> i <br /> — � <br /> Proposed Use ol Bwld�ng Conlract Piice oI Work <br /> Square Footage �i1 resiAential new construcl�un, rcmodel or adddion) Contact Person�Cnnlact Numbed[mail <br /> i <br /> Number of devices(If low voltage) i <br /> � <br /> ' Desaiplion of Work to De Done S e r (/� �a_ ..,�T,�_,e1_e�2�e 7�C1B_�Ps-z►rii�—i��ef��--- � <br /> � ��H c�S s����{_-�_..-���,.��a1'o�c__F�/�_S.a�,s.,�$ ,P_F"�s_r_-- <br /> , <br /> FE[ <br /> CITY OF EVERETT LOCAL SALES TAX CODE I': �105 �/�/S �Jl <br /> (/l/(f V V <br /> I hereby certity fhaf I have mad and exanrined Ihrs anpGcatinn anJ kno�v Ihe sam•�fo be 6ue and - _ -- . -- . -- <br /> conecf All provisrons ollaws anA orAinnnces 9ovemrn9 tbis type ol�vorh �vdl Ae completed -- <br /> whelher spra/icd he�e��i or nof The qranfing ol a pr.nnd does nnl p�esunre(0 9ive aufhonty fo PCP.h11TN <br /> violale or cance�fhe provrsions ol arry ofhe� slafe or locil law regulafing consfroclion or fhe r � ��� _ O�I ' <br /> �)B/fUq1t011CC 0/COf15WCG011 Thal!anr au(honved by fhe o�vnei o/fhis property fo per/onrr fhc C <br /> work Ior wfuch app6calwn is m?de anAl comply�vdh fhe Sfafe Contracfors Law 18 27 RCW and ---_---- - ,_------_ <br /> 296 200 W <br /> ��� n ,— — 1—�- �---��*�---�---�"!`� <br /> Sig aW e � a�� <br /> RCL'rSf00Y05C0�J <br />