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------ ---- — --- — — __ _----- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 475-257-8810 - FAX 425-257-8857 - www everettwa org <br /> 3CO3 �11 C�sino <br /> CUcr[_k� ���.L �S-�(r �u�� �a..-,�r� I � <br /> PROJECT ADDRESS � <br /> �-`-`�-- <br /> OWnef Ma�lA�aress C�ly Slatc�Zip Phone <br /> ��Uc-� n. —_-'-__—. ____._ I <br /> Tenant h1aJ�daress CAy Stale2�p Phone � <br /> I I <br /> ���-L�GL�-r. � IC['�ww+_�W�---�-- � <br /> ElectnCal Conlractor lda�l AdO�ess C�ty Slate2�p Phone <br /> � -98� ' <br /> IStale License Number Contrar� p�ice ol Work <br /> Proposed Use ot f3u�ldmg Contact Peison (Plan Rev�eeq <br /> Square Foolage (If residential new construction, remodcl or addd�on) i <br /> INumber ol devices(II�ow voltage) <br /> IDescription o1 Work to f3e Done�. _�S�*41.�_-�'�_�._S_,v.w /�e�er5 �_} _ 1'u_�` �a�.,.. . I <br /> I _ � <br /> I -- -. _. __- ----- -----�---- -_.-- '----- --------------- <br /> I <br /> I `-- ---- - - -- - ------- -_.. -- -- - ---- - � � --- -�� - - -_.. <br /> I FL=E <br /> I <br /> � CITV OF EVERETT LOCAL SALES TAX CODE IS J105 ��{'� � <br /> lf� � <br /> 1 hemhy r,ertdy Ihn�1 have read and exarnined Ihis npphc,�hon and know the same fo Ae fn�e arrd _ __._____ <br /> conecf. All provisions o/laws and ortlinances yoveminy fhis fype o/woAf wdl be cornpleled ------- - <br /> whethcr spec�hed hemin or rrol The granhny ol a pennd dnes no(p�esume fo grve aufhonty fo PERMIT« <br /> Iviulafe or cancel Ihe provisions o(any olher slate or locul law iegulafing censWcliorr or fhe <br /> pedonnance ol cons7ruclion. That I am nufhonzed Gy fhe owner ol tins p�operty to peifomi Uie E � � � b-O��O <br /> I �vork lor which oppOcabun Is made.ind I conrply wrth(he Sfafe Confracrors Lmv 18 27 RCW anA __ <br /> 296 200 WAC <br /> lolfrll3 <br /> S�gnatwe �` Daie �-------- <br /> „r�;s��i^��ii <br /> - -- -------- --- --- --- - --—-- --� <br />