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p;/3�i/2�'�G 73 SG <br />d,:71`_ P nct,JO• <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMI7 SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857—www.everettwa.org <br />S��S <br />�� ► f�� � vi� �4c�E <br />PROJECT AD�RESS <br />� <br />Mad Addross <br />Ciry <br />� <br />Statr2p <br />Phone <br />TenaM MailAtltl�ess Cipj SWIe2�p y jPhonc <br />�ti'��tin� �� �s� � P6 �x ��� �� 9°e��y 2sY i�li <br />[ICCtri:Al ContfoClor Mall AGdm�.s C�ry S1atn2i0 Phone <br />R.Y H r�.�..! � � � � F <br />SL7te I�CCf15C Nu;ftbe! <br />�'lC ►t / <br />ProposeC Use f Bwlding <br />Square Footage (II rusidenUal new construRion, remodel or adtlition) <br />Num6er of Aeviees (If low voltage) <br />Descnption of Work to 9e Done: <br />CI7Y OF EVERETT LOCAL SALtS iAX COqE IS 31Uti <br />Contract Pr.ce ot Wark <br />Contad Person (Plan Revir.w) <br />1 hereby ceRily lhaf I heve read antl exam/ned th7s appllcAhon and know fhe samn ro De tnre and <br />corrocf. AI! prt�visions o/ faws and oMlnances goveminq fhrs rype o! work wilf be complofed <br />�vhetno� specified herein or noL Tho ,qranfing ol o permit doos not pmsume to Divo aulhonly lo <br />vrolate or cancel the provisions ol uny other sfeto orlocxl law reguln6np ronshuc�Lnn or tfrn <br />peAormance o/ constructron. That I am authwizdC by thd owner uf tJiis pruperQ� to pnAonn Hie <br />wurk lor which app/lcution is mndn nnd 1 rompfy wilh !hn Slero Cont�ctora Law 18.27 HCW anC <br />298200 WAC. //, ,/ � <br />F�( �-QJ ----- <br />`1 <br />PERM3T# — —� <br />E��US-(�� <br />