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---. �-- -1 <br /> �-------- I <br /> 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 <br /> ( � �r��,��1��� i a-� ��c _ <br /> PROJECT ADDRESS <br /> �-���'��f-,(` mHl'� ��� � A� I�v� �r���`�� ��M �l`62��C)�9z5)33.s 33� <br /> Ow�er��^-7 MailAtldress Cily StatelZip Phone I <br /> / ✓/� I <br /> Tenant �dailAddress City State2ip Pho�e <br /> ' ,�1«�,nl� �l� IF.���,�� 16��1���s�R l�r. . <br /> � � s�,����, I��A ��z9n ��>��s-�s�� <br /> Electrical CoM actcr htadAddress Cny Slate/Zip Pnone <br /> �C��'i�/Nl� o5D96� <br /> IState License Number (reGmred) Gty af Everett �usiness License Number(reqwred) <br /> �� � �� �(�r.� � ( 5 G� <br /> Proposed U f Building Coniract(�rice of Work <br /> 1 � + - r�s rac� (2s�)zz�?-3sZzI <br /> Square Foota pf residential new conslruction, remodel or addilion) Conlact PersonlContacl NumbedEmail <br /> N <br /> Number o(devices(If lovi vol�age) <br /> Desc�iption of Work to �e Done: �yLT�F ,EX`�1��(�`i.��vn�'r � �7���`��n—[�n�� �F ' � — <br /> � �// <br /> ��C"iu��rlft l �Eff/�G�. <br /> ._�. <br /> PEE -- <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 �O - DO <br /> 1 he�eby ceAdy t/raf!have�ead and exomined fhis applicafion and know the same to be Inie and <br /> correcf. All provisions o/la�rs and ordinances goveminy fbis fype oI work�vill be cornp/eted <br /> �vhefher specilied herein or noL The granting ol a pennd does not presume fo give authon7y fo PERh1IT/t <br /> violate or cancel tlie pravisions ol any ofher state or local la�v�eguiating cons(rucfion or fhe r I �� � �D , / <br /> peAorrnance o/constn�cNpn That 1 am authonzed by fhe ownerol fhis property to per/onn fhe C `�( <br /> �vork lor�vhich appl�tio%is made and 1 comply�vith the S(afe Contracfors Law 1827 RCW and <br /> 296.200�� � <br /> �� g�/zoiy <br /> �' 3te <br /> " SigaaWre / 9 <br /> r 0 <br /> a�;vseoos.n<�:ow _ <br />