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� � <br /> ELECTRICAL PERMiT APP�aCA�'IC)N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881 D - FAX 425-257-8857 — vnrrN everettwa org <br /> � <br /> "�� �z FOr'L�-f- �Y �i�c�e�"�- <br /> PROJECT ADDRESS <br /> � �" 1 v� �, I �'Iq l Z (=Gr��f-.��� r �t- (.J� UZ�� I - <br /> Ownef hiad�ddress Cdy SlatelZip Phone <br /> Tenant i:talACdress GIy State/Lp Phone <br /> �Vi' ��r�9 �lr<�V�l / �(��'fZ� ��'' �—.1��I.G��'f ��f"�1�r���1F37�f �7�' - <br /> Eleclrical Coniraclor !.a�i Adtlress Cily tale/Z�p Phone �� I � <br /> � �� ���E� ' � � �OU -- <br /> � <br /> I Slale License Number Coniract Pricz of'fJork <br /> 1��51 elr n �!� � I l�w.P �.L�=a,� lC��'�,�,C� <br /> Proposed Use ot Building Contact Person (Plan Rev�ec�) <br /> Square footage (If residenlial ne�v conslruclion, remodel or addition) <br /> Number of devices Qf low vollage) <br /> Ocscription of'floik to �e Done�. �F�(CLC Q�_���.,n�.Q._._�Ci.YIP � � — <br /> ` <br /> I <br /> � <br /> FEE <br /> CITY OF EVERETT LOCAI.SALES TAX CODE IS 3105 `]F O�-/ <br /> I here6y cerlily that I have read and evamined this applicalion and kno�a�Ihe same fo ve true and I J ' <br /> correct. All provisions o/la::�s and ordrnances goveming(his type o(�voik e:ili be completed <br /> whelher specilied heiein or not The granfing oI a permit does not p�esume fo give authonty!o PER�°1TT# <br /> violate or cancel fhe provisions ol any othe�sfate orlocal law regulafing consfruction or the r I � O�/O�� <br /> peAormance olcons(rucfion. That 1 am aulhonzed by tlre owner o(flris property to perform!he t <br /> �:-orh for�vhich applicztion is made and 1 comply ia-dh the S(ate Contrac(ors Lari 78.27 RCW and <br /> 796200 VVAC. <br /> �� � I� J�� <br /> ignaWre Da�e <br />