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-- -- - --- - - -- - - - -- - <br /> �- - - -- - - - - I <br /> � <br /> � ELECTRICAL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES I <br /> 3200 CEDAR STR[ET, EVLRET7, �'✓A 98?01 <br /> 425-257-BB10 - FAX 425-257-8857 - �•�ti+nv.evereltwa.org <br /> I <br /> 1�loya ca.��t AvE <br /> PROJECTADDRESS <br /> SlA0.A C�./E Sm ��ww:�ti �'Jo) Fo.w�.o: wa / 99o�J 6ir) 3�7-w75i <br /> I Gv:ner h7aAAdC�ess Gty StalelZip Fhcne <br /> �AonR�u<. <br /> � S1AfFGRIJ ����Y� ca.�w w.x EW1Err wa <br /> Tenant A1adAdGress Cuy Slate2ip Phrne <br /> 4�r <br /> J..�Nnr�n e��czn�� loo� 10=L�•�c !� /Lo.n�+n w�,�9Be:? �a B�v-49�9; <br /> Eleclrical Ccntra[tor h7ad Addres> Qcy State2�p Phcne I <br /> i <br /> UN�e.>z4aumg �/v[A _ I <br /> .State L¢en;e iJumber Cunlracl Price o1 Vdoik I <br /> ' r�ropcsed Use ot Building Conlad Person (Plan Review) I <br /> I <br /> Square Footage Qf residenfial new construction, remodcl or addilion) <br /> I �JumLer of devices (If Iow voltage) � <br /> L`^__�ci�p'�on of 1'�'oik lo Be Donc�. ,fP,*ae �kt/i.nce 7-��JStJ /�AM�2 v�� N�,� MLD PAnict� _ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��OO <br /> i <br /> I hereGy ccrU(y thal I have read and examined Uiis application and know fhe same to be lrue and <br />. correcl. A/l provisions ollaws and ordinances goveming Uris 7ype o!work wrll be complefed <br /> �vhether specilicd hert�in or noL The gianfing o/a permit does nof presume fo give aufhonfy fo PERMIT# <br /> viola(e orcancel fho provisions ol any otheisfate o�local/aw regulafing consfiucfion or the ^ <br /> performance o/cons(mcfion. Thaf I am authonzed by the ownero!Ihis properfy to pedorm fhe t ( �.�p �- D 3 I <br /> �vorN lor�ihich applicafron is made and 1 compry�vrlh(hc Slalc Con6acfois La�v 18.27 RGW and <br /> 296.200 WAC. <br /> _ 4n^P �y <br /> Si re palr -- <br />