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_ _ _ - _ _-- __-- - ---- - - - - - _ _ _ _ _ � <br /> ELECTRICAL PERMIT APPLICATION <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I 425-257-8810 - FAX 425-257-8857 —www evereltwa org <br /> 2► 31 C he����-� 5f �,ve_u�R— �8�A I ' <br /> I PROJECT ADDRESS c{z�� <br /> ��� _��_�iv����� �'lc�'lDl�lS�.— w�_ �c�Z� � z31- 02�}`� <br /> Owner M17adAdGress City Stalrrl�p � Phone <br /> I SekF ----- -- --- -- <br /> Tenant MadAaAress Gty StateZp Pnone <br /> �S.]--- — --- <br /> , FleclricalContractor Ma�lAddress Gty S1ale�Lv Pnone <br /> Stale License Number(reqwred) City ol Everelt Business License Number(reqwred) <br /> I �'vu� ( . � �ti, -- -- ---- -- I <br /> Pioposed Use of wlding Conir�d Price ol 6Vork <br /> Square�ot ge(If r idential new conslruchon, remodel or adddion) Contact PersonlContac� NumbedFinad � <br /> Number ol dev�ces (II law voltage) i <br /> Description o(Work l0 9c Danc� l��Vr,r(�. �b � "—� ��_��?�_-��'�� - ' <br /> 1 J <br /> ----- — — — - � --- — -- -- -- -. .. — I <br /> FEE i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 `�Ir�v� I <br /> 1 hemby cerL/y(haf I Irave read nnd erammed fhis applicahon and know Bie sarne fo be Uue and _ _. .—_- _ 'I <br /> corrrcf All prowsions ollmvs and orAinances govemmg Ihis fypo ol�vo�k wil/Ge cornpfeleA --��- - �� � <br /> whclher spec�(ed he�ein or nof. Thr. ,qranhng ol n pemuf does nof presume fo 9rve nufhonty fo PERMIT# <br /> violafe or cancel fhe provimons o/any olher slate or loc�l la�v regula6ng construcfion or N�e <br /> pedonrronce o!const ion. Thaf I am nulhonzed by fhe owneral Biis propeAy lo peAorm Uie E � � �0� <br /> wo�k lor�vhich app ah n rs made an cnmpty wRh fhc Sfatc Conl�acfors L aw 18 7.7 RCW anJ _ .__ <br /> 296 200 WAC. <br /> ' 9�/9-� -- <br /> Sig alwe - Date <br /> !+(V,SFD OB06'V1� <br />