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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32U0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www everettwa org � _ 26 —�3 <br /> C i30g-�5�f <br /> �,�oa � le�.�� g�o � <br /> PROJECTADDRESS PD �)c /�/7(0 <br /> �US7u�- ���I�J�Ia�M�.��` -l�!'1-/// ( %'Pe� ----�''����E�Z <br /> Owner Matl Address Ciry Statef7.�p Phone <br /> Tenant Mail Address Ciry St3te2ip � Phone <br /> o wv�r� <br /> EICCInCeI Cof1���clof Mail Address Gty Slalel7ip Phm�e <br /> Stale License Number Contract Price ol Work <br /> J�� — - <br /> Proposed Use o(Hmlding Contacl Person (Plan Review) <br /> Squarc Foolage(II resiAen6al new wnstruclion, remodel or addition) <br /> Numhvr of devir,es(II low voltage) <br /> DescnpUon ol Work to Hc Done �� 0 CIJC� _ PO_�,____ _ ___ <br /> - - - -- <br /> P�/J�����--- -- - <br /> ------ - -- ---- -- — - <br /> �-- <br /> FLE _ - - - <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � j'�� <br /> 1 hereAy cn.rtity�haf I bave read ond examined fhis oppbcal�on nnd know fhr, same fo be fnm. and _ lJ___.___________ <br /> coirecf. �ll piovrsions ollaws and ortlinancr.s govr,ming fhis type ol work will br, complefr,A ------ -- - - <br /> wlrcfhcr spca/icd hermn or nol Thc gran6ng o/a pemiif does not presume fo,ryrvc aufhonty fo pE-RMITtf <br /> violafc or r.encel fhe prov�sions ol.�ny ofhcr sfale or lor.al law regulafing r.onshuc6on or Nic ' I <br /> pedormance o/construclinn 1ha11 om eufhnnted 6y fhe uwner ol(bis pmperiy fo perlomi fhe E I jQ g � I SL i <br /> work lor whicb npplrc.iGon is madc and 1 comply wdb Ihc Sfnfc Conlre�cfors Law 18,77 RCW and <br /> 296 200 C <br /> — � - -- � -- '-- — Q/ 1'���— - — — <br /> Signalure I�Ie <br /> Rrvrst u v."vr i <br />