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I�- _ ---.- ---------�---- - i <br /> ; <br /> ELECTRICAL PERMIT APPLICATION ; . <br /> CITY OF EVERETT PERMIT SERVICES i <br /> 3200 CEDAR STREET, EVERETT, LJA 98201 I <br /> 425-257-8810 - FAX 425-257-8857 —�vww everettwa.org I <br /> ; <br /> I <br /> I <br /> � 5 3 O � �!/�c c,n.e�-r/ �_ <br /> PROJECT ADDRESS <br /> � <br /> � <br /> IOwnet �da�l Adtlress G�ty State/Z�p Phone <br /> —�If1�--,�—g—L��� <br /> Tenanl J 1.1a�,t ACCress Cny StalelZp Phone <br /> �� � - ��'�� �a�—�S'-L.���' '�►u�- 5� ��C ���'�-�—._ I <br /> t � .^ � I _ <br /> Eleciricai Conird��pf ;viadAddress CAy State2ip �e�L��Cj II <br /> � d CrJ � <br /> ���r�L�� � 7 � �� —f��-'�—_0 � <br /> Slate License Number � ° CoMract Price o('Nork <br /> �f.en�..r,�7— <br /> Proposed Use of Buildirg Conlact Person (Plan Rev�zv�) <br /> I <br /> Square Footage (If res�dential new construclion, remodel or addiGon) <br /> I <br /> Number o(devices Qf low vollage) ' <br /> Descriplion of Work to Bc Done: �����__(��'�`� '�`�' —` �`��-"--- f <br /> _ / <br /> FE[ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I I / ,� <br /> l I <br /> 1 hereby ccrtity fhaf I have iead and eramined this application and kr;o�.v the samc to be 6ue and i <br /> coriecf. AI!prowsions o/lan•s and oramances governinc�this fype o/�vork �vill be complefed ; <br /> wliefher speci(ed hemin ornoC The granting ol a pemrif docs nat preswne fo yive aufhonty fo PERMIT:� <br /> vio/afe or cancel fhe provisions ul any o,'her stafe or local la�v regulating constn�cfion or Ihe r If'� <br /> perlomiance o/constn�c(ion That I am zulhonzed by ttie o:vner ol this property(o perlonn Bre c i 31 a� � v � <br /> work lor�vhich app6cation is made and I cempry�t�iflr(he Stafe Con(racfors La�v 78.27 RCW and <br /> , 296.200 WAC. <br /> �����.�-- 1 a--�� -/�_ <br /> Signature Oale <br /> aEvr<eU 92oi,.7 <br />