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p5 �2p!�0'S 0a: 01 360A790iZG =G:]NELSGN EL2CT?.iC :NC M26�C� ?.:^: 'CG': <br /> t <br /> ELECTRICAL PERMIT APPLtCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREEl', EVERETT, WA 98201 <br /> 425-257-8810 - FAX.425-257-8857 -www.everet(wa.org C `a���3 <br /> V <br /> - ' � 13� ��--Il�l I <br /> � � <br /> ��� rD��S�\�iet,t� � i�� <br /> PROJECT ADDRESS _ <br /> �4�� S�i3-�'a�1 <br /> 41�CF.1� I�t ;i'1`liP 9 b�1 FrX'esr v�t;.���2 �a�P��.�^� t,��A-9�2-�"� <br /> . Owner � � � �Mail Address � . � � City _ State2ip Phone <br /> . . . � . � . . . .. . - .. . i <br /> State2i Phone � <br /> Tenant � MailAddress ��i1Y . . , P <br /> 3cv-vs>-s�z� <br /> �, nn 1 ��(�{��,� l� �v rrn d��a�� �A�,-�,� [.ta- 9,12?.3 `/is-355-l�//s' <br /> EIeCUicalContractor � . MailAddmss - . City . State2�p Phone <br /> c .�(� - �`�� <br /> � <br /> State 'cense Number Contract Price of Work <br /> ��nw�.�_ Jon � �.�,��e. <br /> Proposed Use ot Building ' Contact Person (Plan Review) <br /> Square Footage(If resideniial new construdion,remodel ar addi6on) <br /> Number of devices(If Iow voltage) <br /> Descripticn of VVork to 6e Dona: 1 Vl�����1 i�'.� C.��� .. <br /> J - <br /> i <br /> I <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �"]' I� v" <br /> I he�by ceRily that I have read and exsmined lhis application and know the same fo be trt�e and � `"� � <br /> correct. A/l provision.:of laws and adlnsnces govemin�fhis typo of werk will be completed <br /> whethe�spec�fied heroin ornot. The granfing o!a permit does nof presume(o give authonty fo PERMIT# <br /> violnte orcancel fhe provisions o(any othe�state orlocal law regu(aSng constn�ction o�the � <br /> pedoim�nce of conshuc6on. That!am aufhorized by the o�mer o(this property to pedom�the � I �U 5� � � � <br /> work for�vhich application is made and I compty�vith tlre State Cont�sctors Ls�v i3.27 RCW and <br /> 296.200 WAC. <br /> - <br /> . �`� � S/z��'-� - _ ' <br /> �._ . . _ . ..:_. .::_... . Da__ _ . . . . . _ . <br /> R�✓fiED320//7 � . � . <br />