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� <br /> . .:.� <br /> ELEC�RICAL PERMIT APPLICATION <br /> CITY OF EV�RETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> 5�9/7 �✓���f� (Nu �� <br /> PROJECT ADDRESS <br /> �uhr' Ssz,-,� �c,� S S`�!� �iy��.N �-�✓crr � �i� ZJI <br /> I Owner MailAddress City State2ip Phono <br /> l�v��.sr Sti�`�es s`9r� c=�-✓y/rti e��rr �� 7� l�.�'r S3'zU/ — <br /> Tenant MailAddress Ciy Slate2ip Phone <br /> c�,�iu-�E��c�r�� zv�r es�-. �yr sr-�a�x �y WGy.f,�/i r,�,,,� ��zs< <��s-� � <br /> Electrical Contraclor hlail Address City State2ip Phone 5 �,$— <br /> In�UuT�-C..� �I �SI� � /��Ur> `� <br /> State licen e Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Foolage pf residential new construclion,remodel or addition) <br /> Number of devices(I(low vollage) <br /> Description of Work to Be Done: ��U�� �'��� � ��P � � G��s ~' � `' — <br /> -- — � �. � o �r, 5� �� �1�'S1�•."� f�i�aio � 7�r, dV �P c..l �/r�c. c ,d -- <br /> FEE <br /> CITY OF EYERETT LOCAL SALES TAX CODE IS 3705 - ��"�` � <br /> ..� <br /> I he26y ceAify fhal 1 have�ead and examined(his npplicafion and Wiow fhe same fo be Irue and <br /> correct. All provisions o/laws and ordinances goveming this type of worh wi116e complefed <br /> whetherspeci�ed herein ornot. The granting o/a permif does not piesumelo give aulhonty fo PERMIf# <br /> violate or cancel the provisions of any ofher sfafe orlocal law 2gulating consfrucfion or fho � <br /> pedom�ance ol const�uclion. Thal 1 am authonzed by(he owner o/t6is property fo perform the I�' �_ �tl$ <br /> woric Ior which applicafion is made and 1 comply wifh 16e Stafe Contraclors Law 18.27 RCW and � <br /> 296.200 W .� <br /> � � Z` �� Z � /� . <br /> Signature Dalc <br /> aEvrseo aaai� <br />