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� ELECTRICAL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICE� <br /> � 3200 CEDAR STR[ET, EVERETT, WA 582U1 ' <br /> 425-257-6610 - FAX 425-257-8857 —wvv�v everettwa.org <br /> i <br /> � � 0 �� LO L l� 7 /"r�'� _ _ i <br /> I pROJECT ADDRESS � <br /> � ���� ���`/��{� <br /> i 1 lV"� 'Q S�!`✓1 � ��� ��� ���� � —�-- " `'' � <br /> '7vmer �dad Adoress Cr.y 5!ate'Z�a Pfione <br /> �enanl Ma�:P9d�ess C�ly SlaterZ!p Pnane <br /> YV , r <br /> � ! 1.•ctrical Contractor tfa�:F�d�ess C�'y Slale�Z�p Pnone <br /> � ]/ <br /> I :;tate Ucense Number Contra���VJork <br /> �3, ��_POl�c�t \ <br /> I;rp�,=._r� �;eofDv�ltl��g ConlaciPerson (PIanP.ewew) <br /> -1:-�r�� ��- <br /> �o:�arc ' o {ape Ilf residentiai ew construction, remodel or addifion) <br /> � ��urnber ot dev¢es (Il low voltage) <br /> � I'�,s!:����lion of Work to 6e Done ___ l.¢��l_S.Srf_�—���1�j �---�''�—L.'LN_.�Q-J�/—�-� <br /> n,t_�tJ_—r�c-� -Lr��. ��n�.---- - --- - <br /> I itt[ <br /> CITV OF EVERETT IACAL SALES TA%CODE IS 3105 � �� OO <br /> I -----— <br /> !hcrehy mRdy lh�f I havc rcad and examined Ihis apphcahorr and know Ihe sanis fo 6e frue and _ _ _ <br /> correcl An proi�s�ons o!laws and otiinances govemmg fhis lype o!woM rvdl be cnmpleted I <br /> j whr,fher specrfied berem or not The gran6ng o/a permi(does nof presumo lo grve aufhonty(o PFRMIT.7 <br /> v,r���fv orcancel lhe prowsions ol any ofirm sfafe orlo;.;law mgulatmg con5lrvr,Gon o�lire E � �n R � ' ! j ! <br /> pedo�manco o/consfrudion. Thaf i a��i au7homed by Ihe ovmer ol th�s property lo peAorm 1lre <br /> nark/or wlr�ch appl�calion�s m�de and I cumply wrth Ihc Slale Confractors Law �B 27 RCW and _____ _______ . I <br /> I `?� ^ i <br /> I �un;i!��e ���/� ' <br /> I �., ,..;. .-.., , <br />