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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ��.a .../[f <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> �l yo�-0�8 <br /> �() l � C�r� i� �ic. �'� ,, �� <br /> PROJECT ADDRESS C�D2 6 <br /> vl e 7 ,V1a1 � � 't' �� �J>C.�(2S L L^-nKb1S G��- �(25-239-/ov.� <br /> Owner Maii Address City StalelZip Phone <br /> ���f,�� L� ��.�o a�r� ����,'��J� �;��G+/� <br /> Tenanl Mad AOAress Ciry StalelZip Phone <br /> 4� ��•3 .� <br /> ��.��j5 � ��e��a,�c �a� 633 s� �����f- �� ys�� ���-�, <br /> Electrical Conlractor Maii Address Ciry StateiZ�P Phone <br /> �r�14`�-SP� � �DOL4- l� 00 C� <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage (Ii residential new construction, remodel or addilion) <br /> Number ot devices�It low vollage) <br /> DescriptionofWorktoBeDone: �e� �OQ �WI� � le�,�•G�L � �2�<� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 �G, D� <br /> ,/ <br /> I hereby ceAily thaf I have read and examined(his application and know fhe same fo be frue and <br /> correcf. All provisions ollaws and ordinances goveming lhis(ype of work will be completed <br /> whether speci(ed herein�r nof. Tf�e granfing o/a permif does nof pmsume to give aufhonty fo PERMITS� <br /> violale or cnncel lhe provisions of any othersfale orlocallaw regulating consWc(ion or fhe r I �O 1 D �� <br /> per/ormance o/conslrucfion. That I am aufhonzed by the owner ol this pioperiy to peAorm(he C � <br /> work lor which applicafion is made and 1 comply wi(h!he Sfafe Confraclors Law 18.27 RCW nnd <br /> 296.200 WAC. <br /> LAKl���1�Gw��� �G1 //p � �T_ <br /> Signal � Date <br /> ItEV15COY1�LiJ ___'__"_ <br />