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ELECTRI�AL PEF�MIT APPLICA�'ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT: WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everethrra.org <br />�e b `7 ��-��.,,�-� � �-y <br />PROJECT ADDRESS <br />, �:.- �� S � <br />, �� _ <br />Cvmer ' hlad Address <br />�y,('C� � 1A , r"> <br />� l I � % / / I `� "� tJ� !) � C7t.��I <br />Tenant � <br />n �� <br />�� ��ati� 5� <br />, <br />_. �*— <br />E-lectri al Coniractor <br />hlail Address <br />n � <br />,-� �c r� <br />hlatl Addrzss <br />Cr�1P.��'�s� �� 7 J � � <br />Slate License Number <br />�� � <br />\ ` <br />,���rl� � <br />Pwposed Use of 6uildmg <br />Square Foolage Qf residcntial new construction, remodel or addihon) <br />� <br />Number af devices (It lov+ voqayel <br />Description of Wurk to Be Done <br />� <br />� � <br />= �I <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />r�`*� <br />City <br />�; o �r <br />GIY <br />1�1`�'� I �'r � �' <br />Stale/Lp Phone <br />�� %�7�` <br />Stale�Lp Phone <br />'�u �� �� �� �� � <br />—� �ta'��p � M Phone <br />�1 / � � t- • !_ l'� <br />i �'_ "- '' . � <br />� �i <br />Contract Price of `.Nork <br />Contatt Person (Plan Review) <br />G.� Y���� �> �'j �-i :�4- �.� ,Lr_ e � (� <br />� <br />I hereby certily lhaf I have read and exarnined fhis applicahon anJ kno�v the same l0 6e froe and <br />coirecf. All provisions o/ imvs and orzlinances yovemmg (his type ol �rork �wll be complefed <br />svhethcr specified herein ornot. Thc granting al a permrt does nof presume fo givc authenly to <br />wolafe orcancel fhe prowsions ol any ofhur s(ate or localla�v �egulating consWcfion or lhe <br />peAonnance o/ constn�clion. That I am authonzed by the owner ol this propeRy to perlomi Ihe <br />�vork lo� �vhich application is made and 1 comply with Ihe Stafe Confracfors La�•� 78.27 RCVV and <br />296.200 bVAC. � <br />� <br />� �1–��.— � l ` �� ' � �l 7 `-� <br />alure <br />�.---_ . _ _ _ —_ <br />.;:-.� : �: u <br />FFF <br />� OJ <br />�� � <br />PeRr•ura <br />E l ��J�-v (C� <br />