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_- _ _- - _ - _ - - --- --- - -- -- __ _-- _ _ ___ - _ _ ---1 <br /> ELECTRICAL PERMIT APIPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — www everettwa.org <br /> �Ilo� �� ; � ����� ��. z��- �� <br /> PROJECT ADDRESS <br /> �c�rr e�e►� '�( I�b CI� Dr__�,I�te� I�� �1�3 <br /> Owner Mad Address Gty Slate�Lp Phone <br /> i <br /> ITenanl MailAtlCress Gty State?ip Ptwne <br /> �3 �IeU�cu� �jZS� II�M PL St- �—G��'�i�—�1z�-g7o •bs� <br /> Eleetncal Coniractor Mad Adaress Gty s�a�e2ip Pnone <br /> n3 F,�-�3F qSb��l Z�L�o�1 S�I��� <br /> S�tate License Number (required) City ol E rett Dusiness Lice e NumDer(requued) <br /> --'�-Y---- --— . <br /> Proposed Use ol f3uiidmg Conlract Pnce of VJork <br /> �y�U�--�S� ��' �B5 <br /> Squaie Footaye �il residenUal new conslruction, remodel or add�;ion) Gdlffacl Person'Contacl Number/[ma�l <br /> Number ol devlces pt low voltaye) <br /> �y'� �l �/,/,,) t I' <br /> bescnphon ol Woik �o�e Done� _��\'�__��_l PJ'C�I V'�.. �`' n�'�- -✓ --.- .-- . - <br /> – �-�. �(�0 � ?+�/� -�—`���--�`��vovM.- -- - � — _ ` _ t <br /> ���5__�P1����_�—�.J-w�__�R.c.,h �o �4�{�r, 5��,�� <br /> FEE --- -- -- � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 7��� <br /> I1 herehy certitylhaf 1 hTve mad and examined Ihis applicafion and Fnow Ihe samr, fo be tn�e and _�______ <br /> cormcf. All provisions ollaws anA ordinances govemrng Ihis type ol work wdl Ge completed ----- ----- <br /> whclher speGfieAhercin or noL The�Jnnting ot a pemrR does not presume fo grve aulhonty fo PERM[TN <br /> violale or cnncel fhe provisions ol any o(lier slete or locallaw�ngidoting consWction or Ihe ^ � �-I N _ �� / <br /> pr.rlomrance o/consfrucfion Tha(I am aufhonzed by fhe ownerol Ih�s property fo pr,Aonn fhn C V ��' <br /> work lor which applicahon is rn�de and I comply wiN�fhe Sfafc Contreclors l ow 78 27 HCW and ____ rv <br /> 296200 WAC <br /> Sign ture � �-�—�� �I� --- <br /> r� scou �,ar� <br />