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a�e : 3 08/5/7014 03 : 06 PM T0: ] 4252578857 FKOM : 5094570051 <br /> � -----i---- -- -----�--- --- -- --- - <br /> ELECI�RICAL PERMIT APPLICATIORI <br /> I CITY UF EVERETT PERMIT SERVICES I <br /> 'I <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 i <br /> I 425-257-8810 - Fr�( 425-257•8857 —wevw.everethva org <br /> i <br /> I <br /> I ' <br /> � ��'�:� � �'a�-/�/t=�r'�.9� ��/P -- <br /> I <br /> PROJECT ADDRESS <br /> i �� n , <br /> �'iis'�� fSc,}rr.e• CtY%=� �Cyf��.ec�:A-�. 1�,�� i� <br /> � � Cl (�!i" !��/�/�f�7(�)3 �':J'.�:1"i_•7�•`�. <br /> I Owner h7ailAdGtess C�ty SlateZp Phono �I <br /> � <br /> ITen3nt A1ai1 Adtlress Cily State2ip Phc�o <br /> H�'��E-i� /_tl"c';,f'i�_ �" 'Fi�c�X !j'(,� �'"`�E'r �e` Gu9��/CF�G�r ''/��� <c�' ���i� <br /> � Elerinr.al Contractor A1ail Addfass <br /> IC��Y StalofLP Plrone I <br /> i ����D r���c.� 7(� � I <br /> ISiate L�cense Number Contract Pnce of Work I <br /> i PreposcA Use of Bwlding Conlact Person (Plan Review) I <br /> i <br /> I I! Square Foola je(If residenhal new construclion, remodPl^, dddl6on) <br /> I I <br /> iNumber of devices Q(low volta�o) <br /> I Descnphon of Work to Oe Donx�. ��1'�.aiC�LC�(� _(�, C�G�� �'"���a���,`.1� ; � <br /> `�� � � <br /> � -- ''_t�� 7�l.yr/> • � <br /> — � <br /> i <br /> � <br /> FEE -- i <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS J105 �0�� <br /> II hereby r.NrOly tbaf I have road and oxamined this apphcafron en0 knoiv(he same lo he fi1�e anfl . I <br /> correct. All provrsrons o/laws and oMinances goveminy fhis lype ol�vork will bo conrplMed <br /> I �•:hn(her spociCed hr,rein or not. The g�anfrnq�/a p�mii!doos nol presunro fo�rvo aulhonty to PERPIIT# <br /> vwla(e o�ct�ncel Ihe prnws�ons o/any olhei sfate orloca!law reguiaring constrochon or fhe <br /> I perlonnence ol censtn�ction. Thnt t mn aufhonzed by Uie ownei o!(his p�operty lo pe7orm tlie E � �.E � g , 03� I <br /> work/or�t-hich app4cuhon is maUe and 1 compty�tiath the Sla7e Contractors La�v 18 27 RCW and I <br /> 296.200 VVAC. <br /> ��� � .S-�� � I <br /> S�gnaWre p�1e <br /> ' I <br /> aFr.se�z.c��� . .___— _.. I <br /> J <br />