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ELECTRICAL PERMlT APPLICATION <br /> CITY OF EVERETT �ERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 (,f .,5�1 j <br /> 425-257-8810 - FAX 425-257-8857 —wv✓w.everettv�a.org L /3 o y�� <br /> t_�cC15 �' i.�,)� 1 ���1; 1% LC1t� _I� I� °��-'� � �: <br /> PROJECT ADDRESS <br /> �. E ,1 �r�>>(� � 5 �I�ls �� Ib, � l�V� f��t�c-4�' l-J N- y�sy�� � Ic <br /> �', 41 �� �i Staterzip Phone <br /> Owner Mail Address b' , <br /> � <br /> Tenant <br /> Mail Addresa CRy Slste2fp Phone <br /> �Z�Ycrl � lr r � i C �j, � I%� 3oo Ba4t,k.tl ��V�' �Pdi � t'It� �1c'b� 1]��Il t'�c�: �- <br /> Electrical Contractor Mail Address City S�ate2ip Cil�'h�.(; �Z, <br /> � ��U ' <br /> 1�i� � '�� s`15� �r Contra t Price of Work <br /> State License Number <br /> �A� l(�c (I (' � �1� � t�llll�� lll t Il, I <br /> Proposed Use oi Building Contact Person (Plan Review) i <br /> t�2��2:�� u- 174' <br /> 1 �,'t� l; - Z U"t, G <br /> Square Footage Qt residenlial new conslruction,remodel or addition) <br /> i <br /> Number ot devices(Ii low vollage) <br /> 'k� ` � � f� U - t-�„ b�. Y�.,� lc�. � � ��.�,�,.-f' <br /> Descriplion oi Work lo Ba Done: SL ���C. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 `�/j\ �_ <br /> I hereby cettily fhat/have read and examined fhis applicalion and know th�same fo 6e We and <br /> O l.J <br /> I ronect. All prnvisions of laws and ordinances goveming fhis fype of�vork will be compleled <br /> �rfietherspecified herein or not The granfing of a pemiit does not prasume to give authcriry ta PERMIT# <br /> � violate or cancel�he Pravisions oI any other sfafe or/ocal law reguiafing conshuc(ion or Ihe � � � �� / O�� <br /> , peifonnance o(consWction. That I am aufhonzed by the owner of fhis properiy�o pedonn Ihv <br /> ,�ork for which application is made and 1 comply with the State Contracfors Law 18.27 RC W and <br /> I 296.200 WAC. <br /> I � � <br /> ( � ( 1 � C- <br /> ��nal� � Date .. <br /> ;.:„�.:n�,zmu —�-- - - <br />