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-- -- --,-- -- �- <br /> _ _------- - - --- - <br /> � <br /> ' ELECTRICAL PERMIT APPLICATION ', <br /> � CITY OF EVERETT PERMIT SERVICES I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - v�n^n,v everettwa.org i <br /> I I <br /> 'I <br /> ' � �i�.z GYPi2� Sfi. �v��� � <br /> i PROJECT ADDRESS ��� � <br /> i <br /> � Owner �dadAtltlress C�ty Stale;2ip Phone <br /> I <br /> T�< � �rz�M �Y3�z �rPr��ss ; <br /> Tenan� AtailAddress Cdy State/Zio � t/Z� Phore ��, <br /> � Z���c,�?59,�(� EI,��G�'1�c ���o� c� � °rr� S—�' S� LyN�w� ��,_S s�3 �� <br /> i:lectr:wl Contraetor r��au adaress Gry State2�p Phone <br /> ZN.�U��(( g 3 I nJ� ZSo✓ _ '� <br /> Stale L�cense Number Contract Price of Work i <br /> �� � IJ��W <br /> ; Propose.d Use of Budding Contact Person (Plan Review) I <br /> � <br /> Square Footage (II residenlial new construction, remodel or adddion) <br /> ,I <br /> �� Number of devices pf lovi voitage) <br /> y� I <br /> � r �- ,��}-�,t�,/� <br /> I Descnption cf Wnrk to Be Done: L.�R.�iU� � ] lJLi '��u 1 �� C✓J � l.•� ___ I <br /> I <br /> i <br /> I _ <br /> �I <br /> I <br /> j FEE � <br /> CIT"OF EV[RETT LOCAL SALES TAX CODE IS 3105 <br /> yo .�a <br /> II hereby certdy fhaf 1 have read and exarnined this a,oplicaGon and know(he same fo be We and _._—_—__ <br /> � cared. A!I provisions o/laws and ordrnances go�eming fhis(ype o/work�vill be canple(ed <br /> ��:hefher specilied he�ein or nol The granfing ol a pennit does no�pmsume to give authonty to PERMIT� <br /> violate or cancel(he piovisro s o/any other state arlocal la�v regulaGng cons6iiction or fhe � 30 � O D p <br /> perfom�nnce o/constnicho� Tha(1 am a�dhonzed Gy Ihe o�mer ol fhis propeRy Pa peAomi the � � I <br /> �vork lor�vhich applic s n dc and I wrnpty�wfh fhc SWte Confiac(ors Law ib.27 RCW and <br /> � 296 ZDO WAC. <br /> ; �7 — z �- l.3 , <br /> ' . .,- �jnal Date i <br /> i � <br /> I <br /> I <br /> i <br /> .ewsr.�:ata�i� <br /> -- ----------- ------ -- --- --� --- - ----------------- � - - -- ----- ! i <br />