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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org � _ � _ �3 <br /> � '�� G�3°6-Db� <br /> 6C� Z�- ��P,+1 w�e� �(i �l� �:�1'�� Q��3 <br /> PROJECT ADDRESS ,,I <br /> � �l �-��rt.au�.� L �-�' 4�� �+ '� �,,�ie�- `/��3 <br /> Owne� Mail Address Ciry SlatelZip 42�, Z 93 ho0e 4 <br /> .y� <br /> Tenant Mail Address City StatelZip Phone <br /> IJ�C/��� <br /> [ICctricalCon�ractor MailAddress Ciry SIaINZip phone <br /> �rreE w[�/ro/,�3 -- <br /> Stale License Number Contract Price of Work <br /> Pwposed Use o(E3uilding Contad Person (Plan Review) <br /> �43y sg.� . <br /> Square Foolage (I(reside�lial new conslruclion, remodel or addition) <br /> Number of devices (If low vollage) <br /> Description of Work �o E3e Done: �"' ���"���'7 <br /> FEE <br /> CITY OF EVEREiZ' LOCAL SALES TAX CODE IS 3105 � �O� <br /> I hereby cerflly Uraf J have mad and examined fhis applicafion ond know fhe same (o be Inie and <br /> correct. All provisions o/Jaws anU ordinances goveming lhis type of work will be cornpleled <br /> whclhcr specded hercin orno(. 7hc gr�nting ol a pem�if docs nof presume!o give aufho�ity fo pERMIT�I <br /> violafe or cnnr.r.l the provisions ol any other sfale or local law rcgula7iny consfruc(ion or the � ��� �` �� � <br /> pcAonnancc oI constn�ction. Thaf 1 am auUrori�ed by Ihc owner ol this propeAy fo perform Ihe <br /> work/or which app6ca6on is nmde and I comply wdh fhe S6�te Conlractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �,_ �`�� � �Z Z�c.��Z <br /> Si aWrc ��- Dal <br /> i <br /> i��:w^rn v,•ar� ' <br /> . . ------� - -- --- - - - - - � --- ---._ �____ ._. _ ___ . --- ----- ---------- - ------ .. _--- <br /> � <br />