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� ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREl�f, WA 98201 � ,_ I --13 <br /> 425-257-8810 - FAX425-257-8857 -www.everettwa.org � '�o�`D� cr <br /> �n/ ��r��! �2 �v� <br /> PROJECTADDRESS yLS�— �'7g- ySB <br /> �/�12�ii � i� � �Ql ��ARDxIeRJa-ve �ve,�L� l� �r'��3 <br /> Owne� Mail Address City StatelZip Phone <br /> Tenant Mail Address Ciry State/Zip Phone <br /> n O Gr /��fllj/rC/�-� �] � �-�( �� /� �d �C� " <br /> /�{�/�O/lf/�F��'� �c„ ,/�_ / �`�� Phone <br /> Elec�rical ConUactor � Mail Address Cily State/Zip � <br /> 'Zo1.7`7 Q O <br /> �c��v✓v1 e � 9 �i 3c� .S�ooa <br /> State License Number Contract Price of Work <br /> �� �C-f /�i S il -P <br /> Proposed Use oF Building Contacl Person (Plan Review) <br /> � ZS�v� <br /> Square Footage(If residenlial new construction, remodel or addition) <br /> l Co�.t�,rvl1.Q� <br /> �i D 2t �` <br /> Number of devices(If low voltage) <br /> Description oi Work to Be Done: 1� 5 ��k L� �� v` �� �1��n <br /> Q <br /> I <br /> FEE <br /> ' CITY GF EVERETT LOCAL SALES TAX CCDE IS 3105 Gj Q � C�� <br /> � I hereby certily fhat I have read and examined this application and knav fhe same to be tnie and <br /> correcf. All provis%ons o(laws and ordinances goveming fhis type of�vork will be completed <br /> wl�efher speci(ed herein ornoL Tho granting o/a pennit does not pr�sume to give authonty to PERMIT# <br /> violafe orcancel lhe provisions olany othersta(e orlocal law regulating consfrucfion or(he r I � ��� ` C, I C� <br /> pedo�nance o/constn�ction. That 1 am aidhonzed by fhe o�vner o(this prope�fy to pedorm the C � � <br /> work lor which application is made and 1 compty with the State Contractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> �/I/Y�-� � p �� /- / � <br /> ignaWre Date <br /> REVISED Y2W17 — <br />