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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 —�+nvw.everettwa org <br /> �g,�oy �oa`� <br /> IC{ .-2-8��� <br /> PROJECT�DRE 5����� <br /> � y2S=?�S�-9z3Z <br /> �Le.� �--�, c�e.wl-c� �I � 4S �v.�.+z�r-e.e�-, v w,-� �vE,,.�.-�'�} �.�h `1 � y <br /> Owner At�;l Address iry Slate/Zlp Phone <br /> � TOnant hlailAtltlres5 Gry Sfate/Zip Phene <br /> i PrG�-ec,-�t�,-� '-J- 22vZ6 �X� �ives • �.na- w� `��J3Z Zs3 ��K►u v <br /> � ElectricalContractor htaiiAtlaress C� <br /> ty StatelZip Pnone <br /> _�i�v c�-�33 3 P 3 ��i'� 3 <br /> State License Number(reqwredJ Ciry of Everett Bcsiness License Number(required) <br /> �.J �/ lJ <br /> iPraposed Use of Bwldmg Contrect Price of Wark <br /> iSquare Footage(If residential new construc6cn, remodel or add�uon) Contact Person/Contact NumberlEmail <br /> � <br /> Number of devices(If low voltage) <br /> i Uescrip(ion of Worh to ee Done: r3'C��J\ C'2. �,� C(jY1l�)'l l/1'1 i �(�.,� � ���\u') <br /> IFE[ /)�,Vy� <br /> : CITY OF EV`eRETT LOCAL SALES TAX CODE IS 3105 ) � � <br /> I r <br /> i I hercGy cerlily fhaf I bave read and ezamined fhis applicafion and kno�v fhe same fo Ge liue and <br /> correcL All provisions of/aws and ordinances goveming fhis type ol work�vill be completed <br /> whethe�spocified herem or noL The grantin9 0l a perrruf does no(presume(o give authonty to PERMiTk <br /> wolafe or cancel the provisions ol any other sfate or local la�v regulaling constiuction or the ^ � ���- O� <br /> perlonnance olconstruction. That l am authorized Ay the owner o!(his property fo perfomi!he t <br /> , work 70�whi - plication is made and I compfy vii(h the Sfate Contrac(ors La�v 18.27 RCW and <br /> �� 296 200 W C. � <br /> �/�� �� <br /> S�_ ature Dale <br /> � <br /> I <br /> � r,w;-ocac�:ro�a <br />