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• s <br /> � -- -- --- -- -- <br /> � ELECTR��AL P�RIVIIT �P�O..BCAT'9C�i� <br /> I CITY OF EVERETT PERMIT SERVIC�S <br /> � 3200 CEDAR STREET, EVERETT, b�!A 98201 <br /> i425-257-8810 - FAX 425-257-8857 -tis^.vv�.everetLaa.org <br /> I <br /> I '�l� (`7 C6 I (�� <br /> PROJECTADDRESS <br /> j "�,�� ,�1,(I��e �1�i7 cG ► �v ����e� lA.��- <br /> owner MaJACtlres, Cny s�ata2�p Pnone <br /> � <br /> � Tenanl 67a�lAddress C�ty StatMt�p Phone <br /> � /qCe°� ����, �ar�` �riOf� 57'S ���`2'��" �-l��?`)F�C� y �3�- //S <br /> � [IeclricalConira[tor MaJAddress Cdy Slate�Zip Phone <br /> ! _ �CE'�E � l �( �/� .�i <br /> 5!ale Litense Number Coniract Price cf Vdoik I <br /> I � �'� � <br /> IFroposed Use of�wid�ng Contact Person (Plan Revie�v) I I <br /> I I <br /> j Syuare Footage Qf residential new construclion, remodel or addition) i <br /> � � <br /> � Number ol devices Qf law voltage) � <br /> -,L /r '/� /� I <br /> L'escription of Work tu Be Done�. _�ti�� '4� � � f� �J— /'"���rJ wK e'2� �V��C��C�� � <br /> 1�Qa� �� o� 0�2. f2.oc� '� �b Ny. r 5_ �'_� c�bC3 �w��i1 SC�✓Z�rcH___ <br /> � _ _ <br /> I PEE � � <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 9105 �O� I <br /> I hereby ceRrly thal i have read and e,ramined this appfica(ion and kno�v lhe same fo be lrue and <br /> cnnecl. All provisions o/la�vs and ordinances goveming(his type o/�vork wtll be complefed �� � <br /> c�hether specilied herein ornot The granfing ol a permit does not presumo fo give aufhordy to pERMIT;t I <br /> v,olale or cancel lhe provisions oI any ofher sfate orlocallaw regula(ing constrvction orlhe � I, I O��I O !, <br /> peAormance of construcfion. 7haf I am aulhonzed by fhe owner o/fhis property to pe�form the `� � V <br /> ivurk lor�vhich applicafion is made and 1 comply wRh the Sfate Con6aclors La�v 18.27 RCW and I <br /> 2?6200 WAC. <br /> �3�2.�� �—�c��l �/ <br /> Signat��c ���e I <br /> � <br />