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� ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org � � �� ,_�y <br /> C— ��col -� 5 <br /> 31� � Col��► �,��c w� gewd <br /> PROJECT AD�RESS <br /> F,rc.ti� 5.�� ec��� �lu� Col�., Y-�x�k I.tJ�C g�1�6 �LS�1'112t <br /> OWnef ail Address City SlatelZip Phonr. <br /> Tenani Mad Address Ciy SIale2ip Phvnc <br /> �A�VS�c �oeS� Fa V kC\G1�� �i(�jyl.S Z�-13 9���' ST Sr �vU�� (�� l�Z�a �{�S'a3J 3g�lU <br /> Electncal Contraclor Mail Address Cdy Slale/Z�p Phone <br /> In)e5�cc c.��l�k PC2 32, 600 <br /> Slate License Number CoMracl Pnce of Work <br /> o��;� �d�.� K c� <br /> Proposed Use ol Building Contacl Person (Plan Revicw) <br /> Do <br /> Square Foolage Qf rosidential new construclion,remodel or addilion) <br /> Number ol devices(If low vollage) <br /> Oescriplion of Work to Be Done: � ��et�S �"��i�,t, ��^ ���� <br /> (�cI �� � D�.����CS � OC Ll/� �F'�iCe • .UeIJ / ttY.u�ti S <br /> �7��� ���,�4d <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 J�`�I "`� <br /> l <br /> 1 l�emby Coddy that I h,rvr. m.ad and exernined Ihis application and know fhe samn In be Irue and <br /> conecf. All pmoisions o!laws nnd erdinances goveming fhis lype oI work wdl be complefeJ <br /> �vhefhr,r specdrr.d herem or noL The gran6n�of a pemiit dor,s not piosume to give aulhonty fo PERMITN <br /> wnlate or cancel fhe prtrv�sions of any other slafe o�local law reg�dafing r.onslniclion or fhe <br /> pe�fommnce o/cunstnrr.fion. Thaf 1 arn aulhorzed by U�e owna ol lhis propr.rty lo pedomi Ibe E I y D I —O�� <br /> work Inr whiG�applrcabon is made and I compty wifb fhe Slate Conhar,lors Law 78.27 RCW nr�d <br /> 29G 200 WAC. <br /> �L� Signalur�� ������ '� <br /> atvlsrn»rvn <br />