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�— - — <br /> ELE�TRICAL PFRMIT APPL�CATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.gov <br /> C-� si o_ �a� <br /> �a �-l5 �-15 <br /> �l I I �J C � .� � �� C 1����U� <br /> PROJECT ADDRESS� �d,�✓ � /��I�1,�����' �2Sl <br /> �2�,� (� �jy �� L�3U�, <br /> Owne'----�(� M:rl Address Cily Stalr.2ip POone <br /> TCnaN Nail Address City Stale2ip / ,� ��hone <br /> ��►u�Ll� �'' G l�iJ1� �' n���`P -�� <br /> ElecViCal Coniraclor ldail AdAress City Stale2ip Phone <br /> ��i�s� �Z�P <br /> Sla �License Number(required) Qty oi Everett Busmess License Number(reqmred) <br /> Proposed Usc of Bullding Coniracl P��(OWork � II <br /> Squarr. Foolagn(Ii residential nr.N consWclion,remodel or aAddion) Contacl PersoNConlacl NumberiEmail <br /> Numb�r of dev�ces(II low voitage) <br /> Descnphon ol Work lo Br.Donrz�. MGy/� _ O U�I�_j�_GU_�SlGL_L_f�._ - �G'` — — <br /> �L�:ln��Z�F�L -1 C /a� c <br /> FEE <br /> CITY OF EVERETT LOCAL:iALES T/U(CODE IS 3705 SG � <br /> I hereby r.ertily fhnf 1 have iead and exnminr.d Ilus applicaM1on anA know 1hr. sarnr. fn bn We and _,_ <br /> correr.L AN pmvisions ol laws and orAmances govemmg Ihis lype of work wdl hc mmplcled <br /> whefher specdir.d hr.rcin or nof. Ihc grmiting o!r�pemuf dor.s nol pmsume l0 9rve aulhonty ro PERMIT# <br /> violafr.or cmicel(he prows�ons ol ony ofher slale m I.�cal law rr.gulatmg construchon or fho E �51b� '^ A <br /> per/omiance of conslmr.6on. lhaf I am nufhonzed by fhe owner o!Ih�s propeAy fo pednrm the LV <br /> work!or whir.h apphcahon is rnade and 1 tomply wilh!he Sfale Confracfors Law 78.27 RCW end <br /> 296.200 WAC. <br /> ��e1 �51201" ✓ _ <br /> ue <br /> acvr,:i.n tw�u.:ni. <br /> � <br />