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� _ _ _ _-- --- <br /> _. _ _ __ - - -— _ __ _ --- --- <br /> � ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320Q CEDAR STREET, EVFRETT, WA 98201 <br /> 425-257-6810 - FAX 425-257-8857 — www.everettv+a.org <br /> , �y/S_ <br /> � � � � 2 � �v�- �� �`� � <br /> I PROJECT ADDRESS I <br /> I l�c�_o�-� �-�'�.'sfirJGt�D�J j <br /> iOwner A7ail Address City Slate2ip Phone I <br /> � <br /> Tenant h7ail Address Cily SlatelZip Phone <br /> uzs= 73�7 � <br /> � ����e'S ���,d'�'i .� G /��L�G�2. �/�✓� �Ir��,e��'�✓ w��7�2Z3 33�3 I <br /> EleCtnCal Conlractor A1ail Address City Slale2ip Phor,� I <br /> '� _� <br /> �1�,�� �i �� 9U� 3�� � <br /> State License Number CoMract Price of Work i <br /> C./ TT� L e._. /L� �C. lo,� �' <br /> Proposed Use of Buitding Con�act Person (Plan Review) <br /> � i' <br /> � Square Fo tage (I(residenti;.l new construction, remodel or addnion) I <br /> Numbar of devices(II low voitage) <br /> Description of Work to Be Done: �Q.n �U� I�—1 ,�,����� ""-J�� � � � I <br /> � <br /> FEE � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 �� �] �G� � <br /> v� <br /> I here6y certily fhat I have�ead and examined fhis applicafion and know fhe same to be Irue and <br /> cormcL All provisions o/laws and orciinances goveming Ihis type o(work will be comp/efed <br /> whether specificd herein ar not The gran(ing ol a pemiit does not presume lo give authonty to pERMIT� <br /> violafe orcancel fhe provisrons of any ofherstate or locallaw regulafing consfn�cfion or the <br /> peAomiance o/consfruction. That I am au(honzed by the owner olthis propeRy fo perfomi the E (�D a�b�� <br /> work lor�vhich apphcafion is ade and I comply wifh fhe Stafe Confractors Law 1827 RCW a�d <br /> 296.200 WAC. " <br /> � t z�����- <br /> ignalure Date <br /> FCL"GLD;:G�.' . <br />