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� � <br /> I-- — - - -- -------- - - -- ---- <br /> EL�CTR�G/�L PERfVIIT' �P'�'LB�A�"BG��9 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, 6VERETT, 4VA 98201 <br /> I 425-257-8810 - FAX 425-257-8857 —vrvrw.everettwa org <br /> ! �/7�Z W�Si G-�c� /����.i o�Z <br /> � PROJECTADDRE55 <br /> � _..1�m L�es� �/�o� i� G � ��r-���-• 02 <br /> � Owner .t.taJAddress Gly Slale2�p Phone <br /> I <br /> I TCnan� b7adAdtlress Gty Slate�Z�p Phcne <br /> '��3�J'z �l�i �j9o2 �95� s-� ��/��/�eo w� 98z�;� <br /> �' [Iecirical Conlra�tor F:1ad ACdiess Gty State2�p Phone <br /> ' y//��, ss 9s/ Q 9 3v� � <br /> ! �:—�� Contrect Pnce of VJork <br /> , lale License Ntnnber <br /> � <br /> �� Proposed Use of Buildmg Con�act Person (Plan Revien) <br /> Syuare Footage(If residenliai new conshuclion, remodel or addition) <br /> Number of devices (II low vollage) <br /> Description of Work (o f3e Done; /! ��2�v s�i2��Ge �U� � ��UG� - — <br /> c���v��7_�� 6�L� <br /> I - <br /> � <br /> FE[ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �//_ d� <br /> ( `:J <br /> 1 hereby certdy fhat 1 havc read and examrned(his applrcafion and kr:o�v fhe same fo be true and _ <br /> correcL AN provisions of la�vs and oroinances goveming this fype ol�vork n-ill be complefed <br /> �ihelher specdied herein or nof. The granfing ol a pemrit does not presume fo qive aufhonty fo PERMIT7 <br /> vrolafe or cancel the provisions ol an y other sfate or local la�v reg�laling consfrucfion or fhe /� <br /> � peAormance of construclion. Thaf I am aufhonzed by lhe owner o/fhis preperiy to pe�fo�m fhe E '�Q5� � �V <br /> I r:ork/or�vhich appdcafion is made and 1 comply�rith fhe Sfate Conhacfors Lav� ]8 27 RGW and <br /> 296 200 WAC. <br /> _��/\_p�_. �r�c�f.� .S'ZO-/�� <br /> / / S�gnalure Datc <br /> U � <br />