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�---- -- — - <br /> ELECTRICAL PERMIT ApPLIC�4TION <br /> CITY OF EVcRETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, lVA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -wvrvv.everefriva.org <br /> 52o c� <br /> �, �- 4 �l'��s� t�,W-�-� <br /> PROJECT ADDRESS <br /> Owner Mail Address Ciry Slate/Zip Phone <br /> /� <,l ��.�1-l�r�� �..�Yz✓�eu,�u CJr1� a �r•3aa- <br /> � ��lp ��3 �� <br /> Tenant Mail Address City �iate/Zip Phone <br /> lyay ��.�,�-s��� 't'u�-`vT 3��vc�lgaa� <br /> ��I��t�tA- F�g.G72�'� r.�c V�,�.� u��19$2�� <br /> EleClfiCal Con�fador Mail Address Cily Slafe/Zin Phone <br /> ���tit�+EL�yo .� �. � <br /> Slate License Number Contract Price of Work <br /> C��,� 5�o�e� MuG�t Gam�. <br /> Proposed Use of Building Contact Person (Plan Reviev�) <br /> Square Fc?lage (If residential new conslruclion, remodel or aadition) <br /> _� <br /> N�,nber of devices (if luw vol�age) <br /> Description of�Vork to Be Done: �c_�'T6L�IVQ �ccK� C�-/z� ( I ZT� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 r'-] S � <br /> 1 hereby cedi(y that!have read and examined this application and know fhe same fo Ge(rue and J ( `� <br /> co�ect. All provisions of laws and ordinances goveming tl�is type of work will be complefed <br /> tvhe[herspecified herein ornoL The granting o/a pemiit does nof presume fo give authonty to PERMIT# <br /> violate or cancel fhe provisions ol any olher sta(e orlocal law regulating consfrucfion or the ^ ���� — O i <br /> peAomiance o/conslrucfioa That I am autlionzed 6y the avner o((his property(o pedomi Ihe t a <br /> woifc for which application is made and I comply wifh fhe Sfafe Conlractors Law 18.27 RCW and � <br /> 296.2 WAC. <br /> ` � , - � /a �p I <br /> Signatur Da � <br /> _ renseoa,m:� _ i <br />