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ELECTRICAL PERMIT APPLICATION <br /> GITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAY. 425-257-8857 -www.everettwa.org <br /> � <br /> f,� � Qy ��.�o��l H�'� <br /> PROJECT ADDRESS <br /> �� . �� o U CCI <br /> Ownef Mail Address Cily Stale/Zip Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> 2`i2S 1lb'�� PL 5� �`�Se�# �,.atr `1820� ��zS-S�o•C�8� <br /> �� fZ�'�Cj�' L Phone <br /> Electrical Contraclor Mail Address Cdy State/Zip <br /> �:� c � �3�.��s6��-� 5�`�� - <br /> Stale License Number Contract Price of Work <br /> �i7(' `c .��. .S�Tpr� _ �'�--N.t�p.--t. <br /> Proposed Us " f Building Conlact Person (Plan Review) <br /> �(=Lh�'\ k-K'C�hli. <br /> Square Footage (If residentiai new construction, remodel or addition) <br /> Number oi devices(If low vollage) <br /> Descriplion of Work to Be Done: F�'.> �9 `"� {° + �'' L ��� f �t��'� • <br /> i <br /> �,oa - � K� a lr W�.�. 'n�r��S � /�on sw•1ri�1.Elr.� � <br /> I FEE <br /> II, ClTY OF EVERETT LOCAL SALES TAX COUE IS 3105 � � Z �� <br /> � 1 hereby certily fhat 1 have read and examined fhis opplication and know the same fo be fnre and <br /> Icorrecf. All provisions o!la�vs and ordinances goveming this type o/work�vill be comple(ed <br /> I �vhefher speci(ed herein or noL The granfing ol a permit does not presume to give authonty to pERMIT# <br /> violale orcuncel fhe provisions o(any otherstafe orlocal law regulaling consWction or(he � 7�Orp _ 0 ,( � <br /> '� perlormance o/construcfion. That 1 am nulhoiized by fhe o�vner o(tliis propeAy to pe�lorm the � `"� `� <br /> ' �vork lor�vhich apnlicalion is ntade and 1 comply wiNi Ihe Stafe Contracfors Law i8.27 RCW and <br /> � 296.200 WAC. <br /> i <br /> I � � f(1 ',��� � � 7j <br /> elurB � �ate <br /> - _.,�:.6n ------- ----- -- — .... _ . <br /> - r �-- . ----- ----— -- ------- <br />