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_.� _._ __ __ � - -- <br /> � ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR SIREET, EVERETT, WA 98201 <br /> 425-257-8810 - FP.X 425-257-8857 — www everettwa.org �,=�yiz-14 y <br /> ,a_i9�-/y <br /> 3 � 03 t..� . C�.S � r. o K � ��� -a� , �1�0 � <br /> PROJECT ADDRESS <br /> �.�e,�� } .�- ��e��^- <br /> —`3-- --- --- <br /> OwnM IAail Ad9ress Crty Sla!e2in P�wnc <br /> � V_� V ,__��V� ____ � __. .—__.—__ _ —_ ' <br /> Tfnant IdadA09ress City StatorL�p Phonc <br /> sey �o�al^ _ ��c ��i �. � ! � !'i� �,�"�T fL�J, .ti.—�1,�—_wA _ _ <br /> FlecincalConVador MadACdress Ciry State�Lp Pnone <br /> S i: ca�o�� 9'"i'l �`l _ '-�°6 H S <br /> State License Number(requ�red) Cdy ol Fverett Business License Number(reqwreA) <br /> .���.�_O S �—_.._—._ . _ <br /> Proposed Usc u1 Dwldmy Contrad Pncc ol Work <br /> ��AS �' 1-�n.� Qrto ✓1 _—. . <br /> Y—_'__._ _— <br /> Square Footage (If residential new cunstruchon, remotlel or�addd�on) Con1aU PersonlContacl Nwnber/Erna�l <br /> ao(, �<< 3 - soo �1 <br /> Number of devices�Il low vollage) <br /> Descnp6on oI Woik to Be Done —_ 1.+g-�ti� �3(. ) h1 cy Ll' /J `'X�ttiie -5 —�--- <br /> n �<<��.. ----...— —.. -- -- <br /> __��N_L1�•< — � �------ <br /> FEE <br /> CITV OF EVER[TT LOCAL SALES TAX CODE IS J105 '7 �� <br /> , � �y-� - <br /> 1 hereby certrly thaf 1 have road anA r.xamined(his applical�on and krrow Ihe same to b� fn�e and i __ _ __ ._ _. __ _ <br /> conecf All provis�ons olla�vs anAordinances govemmg(his type o!work wdl be conrplefed -- -- — -1 <br /> uherheispecified hemin ni not The yranfmg o/a penn�t docs notpres�nne fo give aufhonty to PFRMfT# I <br /> v�olale or cancel fhe provisrons ol any ofhei sfafe or locallaw regulafin9 consfruction or the (� <br /> peAonnance o!consfruction Ihat 1 am aufhonaed by the owner ol fhis property fo pr.Aonn fhe E I 1 I Z .- I� � J <br /> work lor whiclr apphcaGon�s m�de nnd 1 comply wdh the Slate Confracfors Law I8 27 RCW and _ l ____ _ <br /> 296.200 WAC <br /> J�/ �� �j� I-� _ <br /> ---� Siqnatur Oale �— <br /> nE195co Ce06?oia <br />