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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDf�R STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.org �_ + 3 �� 3 <br /> G �30 5--°5( <br /> ��1�� J������ -��� � �✓�� <br /> PROJECT ADDRESS <br /> �5A� �c���'� I bc,i � loSso� ��C <br /> Owner MailAddr=,;s Ci;/ State/Zip Phone <br /> ( ( � l/�lI�IGG� X �UGI � <br /> Tenant MailAddress City State/Zip Phone <br /> ��i� /v��� 1 S/5 �/J �✓� t✓a-� �-�V IZ�F l�P�'G-rv.� t G✓� ���Z7 � _ <br /> EleCl cal Con.facto� Mail Address City Slate/Zip � Phone <br /> � !��' - 7S)�yi17�j <br /> �� Sr�� i^�1LG-(' - <br /> ��I ��'� < <v <br /> S�ate License�mber Contract Price ci Work <br /> C � �✓� VVl Ol/�GL�' <br /> �/�Ji�� S �V � <br /> Propos�t Building Conlact Person (Plan Raview) <br /> � �l U l `��1 '� <br /> Squa e Footage (I`residential new consiruction, remodel or addition) <br /> Number of devices(If low vollage) <br /> DescriFiion o(Work t Be Done: I �n`�` � C7��/� � r ��U� t— C� <br /> � 1� � �� <br /> � <br /> FEE <br /> j /'� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �D • OV <br /> I hereby certi/y thaf 1 have read anJ examined this applicati�n and know the same to be lrue and <br /> con'ecf. All provisions of laws and ordinances yoveming Uiis type e(wo�}c will ba compfeted <br /> whetherspecified herein ornot. The gran(ing o!a pemiit does not presume fo give authonty to PERMIT# <br /> violate orcancel the provisions of any otherstafe orlocal law regulating consln�ction or(he <br /> peAomtance olcoqsWction. That I am authonzed by fhe ownero(this property io pedorm the E � ���� � <br /> �•eo�lc/or whicfi ap�'lication is made and 1 comply with the State Contractors Law 18.27 RCW and — _ <br /> zes.zo9 wac//� J �] <br /> �` ��'�/( {;/J�/ ( �� �j i�?—� . <br /> I ignalure 1 C Date <br /> vewsr-o+rai� — —J <br />