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ELECTRICAL PERMIT APPLICATIOtV <br /> CITY OF EVERETT PEP.MIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> j <br /> I <br /> i <br /> I <br /> L ( 1 <br /> �� �� ` \��n��� \��\� I <br /> PROJECT ADDRESS <br /> --1���`�—'('��'�-�� ��, ►�i��c� ��i �o �.,.�,��� (,�� (:��' � °�g2D i 4tis13�-�81,. <br /> Owner Mail P.ddress Ciry State2ip --r Phone <br /> �'1( �1l"u-- � <br /> Tenant Mail Address City State/Zip Phone <br /> 5�c�� ��������,�� � ��� °�s� (�2s1 ��s- 6��o <br /> EleCiriCa�Coniractor Mail Address City State2ip Phone <br /> I <br /> S1�rrJl�l� C��?� C'���5� - , <br /> State License Number(required) City of Everetl Business License Number (required� <br /> �F� ���� � ��U ^ <br /> Pr posed se of Building Conlract Price of btibrk I <br /> ' � }� ��t15> �I1�-O��Z ! <br /> �� � � <br /> Square Foolage Q(rusidenlial new construction, remodel or addilion) ontacl Person/'xLontact Number/Email <br /> Number of devices Qf low vollage) <br /> Descriplion of Work 10 De Done: �� �'G�r (�,�,������(� �l���a� �"!'U'� „' ` '*" �'� <br /> � <br /> '�? ,�� ��51G�� <br /> FEE <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �O w <br /> I he�eby ce�tify Ihal 1 have read and examined Ihis applicafior, and knmv fhe sarne lo be fnm and <br /> Icoirect. All provisions cl laws and ordinances goveming this type ol work will be complefed <br /> whether speci(ed hefein or noL rhe gnnting o(a pennit does nol presume fo give authonty to PERMIT# <br /> violafe or cancel(he provisions o(any ofher sfafe or/ocal law regulafing conslrucfiwi or fhe r 1 � O � , �1` � <br /> omian olconstruction. That 1 am aufhonzed by fhe o�vnero/lhis prope�ty fo peAomi the C � LJ` <br /> r�ork(or �hic�applica(rcn�s made and 1 comply with thr. Sfate Contracfors Lav�18.27 RCW and <br /> 296.20 A ----- ---- - <br /> --- Zj26�� S �=` -�- <br /> S gnat �`� Date <br /> I <br /> � _ _ ____ _� <br /> fteV�SEDOBv6/1o�a -- <br />