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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER`✓ICES `� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �o—a� � <br /> 425-257-88�0 - FAX425-257-8857 —www.everettwa.org C �3o6•-((�`'1 <br /> r-; , r <br /> �� I �!- (�G'��E'�' <br /> PROJECT ADDRESS <br /> , /�,�� ��CC� �� ����" �` ��'� -- <br /> Cit State/Zip Phone <br /> Owne� Mail Address Y <br /> Tenant <br /> Mail Address Ciry Sta'e/Zip Phone <br /> _I,._�,—��t��YUV� u i� ,(J �7 OX � c�Z`� l���-{�l.uk,L\ C n//�- <br /> C- �' Phone <br /> [ledrical Contraclor Mail Addreas C�;y State2ip <br /> � <br /> � / � ��� <br /> � � �� ('C ���G' �� �� Contract Price of Work <br /> State License Number <br /> Proposed Use o(Building Con�act Person (Plan Review) <br /> �,-(Y% <br /> Square Footage (If residential new construction, remodel or addition) <br /> Number of devices Qf locr oltage) i' <br /> � r / / L� i <br /> ' �' I <br /> .�"'/_� � ',a, l����` / � <br /> Descriplion of Work ta Be Done: � �'' ��v��«G��i � F "� �f" �` <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 �5 �";�; <br /> I hereby certily that I have read and examined this applrcafion and kno�v the same to be true and <br /> conact. All provisions ot latvs and o���nances goveming this type o(work�vill be completed <br /> c✓hefher specified herein ornot The granfing o/a pemiit does not prEsume(o give authonty to pERM1T# <br /> violate or c�ncel the provisions oI any olh��r,fafe orlocallaw regulafing construction ortfie � 1 -�C (, _ i � � <br /> perfonnance ol construction. That 1 am authonzed by the ownero/this prope�ty to peAomi the � �4 <br /> i �-�ork for�ihich applicalion is made and 1 cZ�mply with the Stt�te Contr�{cfors La�v 18.27 RCW and <br /> 296.200W��. .� '� /� ;� - � <br /> = --7 , � L � �� .-, <br /> �. ��L�� /li�� �1��� l �_ <br /> 'Signature �' Date <br /> i <br /> r.ev�sco�:o�u — -- <br /> � <br />