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ELECTRICAL PERMIT APPLICATION <br />CITY OF F_VERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 C( ,, p a- `/3 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org C � 3� p,� 3,� <br />� � 4� � S l_ �'"�� 7-C�v_� (_�v w��l <br />PROJECT ADDRESS <br />Owner Mail Address <br />J- ���J��v�e � <br />Tenanl <br />r_�ere t�t,��� <br />� l t� �l 1�4��� (iR � C <br />Mail Address <br />City <br />City <br />State/Zip <br />State2ip <br />Phone <br />Phone <br />��� �l 1:: 2N�1'1 \�'� � 1�'�-i�iL�L �� �; �oY �izZ �i�iN��/l �VA `�25 S7[, ZSS z73Z775 <br />Elecirical ConUactor Mail Address City State2ip Phone <br />� L-i i�. �V [� �"� 'i�C � Lt�) <br />Sta�e License Number <br />Proposed Use of Building <br />Square Foolage (If residential new conslruclion, remodel or addition) <br />Number oi devices (If low vollage) <br />� I.JSo,�,� <br />Conlracl Price of Work <br />Contac( Person (Plan Revie�v) <br />Description of Work la Be Done: L- r�� �� � ���'��' �� ��� ��� _� Oc�L �n— �- C 1� `S <br />CITY OF EVERETT LOCAL SALE ; TAX CODE IS 3105 <br />1 hereby ce�ti(y that I have read ard e.ramined this applicalion and know the same to be tnie and <br />correct A/l provisions o(la�vs and ordinarces goveminq this type ol work will be completed <br />a�hetherspecilied herein ornoL The granting oi a ponnit does nof presume fo give authonty to <br />viola(e orcancel (he provisions of any otherstale orlocallaw regui�ting constniclion orfhe <br />pe�fommnce of const�uction. That I am authoiized by C:A ownerol this propedy fo pedonn the <br />n�orklor �vhich application is made and I comply wifh the State Confracfors La�v 18.27 RCW and <br />296.200 WAC. <br />ieev�s��n i�za�� <br />Z� /3 <br />FEE <br />`fh-i�- C'L' <br />P[RMIT� <br />E � ',�, `_� - G' �.35 <br />