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---- -� -------___ ---�-- - ---- - -- _ — <br /> ' �i <br /> i ELECTRI�AL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVdCES � <br /> i <br /> I 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810 - FAX 425-257-8857 - wv✓w everettwa.org � <br /> i <br /> i <br /> I �o�r��s S- ��/&� �2�J � <br /> ; PROJECT ADDRESS I <br /> IOv:ner � 1dadAddress Cny State/Lp Phor.e <br /> i <br /> L�'�-/ S� � , <br /> , lenant ih�spuCe �eC-4-� trlad.`.ddress City Statcil.�o Phone . <br /> ;�5� �o( � ( ���`� S� ��--� L)� �� <br /> � EleUncal Conlractor toiad Atldress C�ty State�7�p Phone �� <br /> Z�vn.��-1 `� � ( N.� <br /> Stale License N�+mber C�ntrect Price of Work <br /> i �4g d� ' <br /> ProposeA Use ol 9wldii g Contact PP�son (Plan Review) � <br /> Square Footage pf residenUal new construction, remodel or addition) <br /> Number of devices (If low voitage) �I�i <br /> Destnption of Vt�ork �o He Cone: �� �I�C Ua""l�E �'"'�" ��� /��/w���u� 7vN�lJ _ I <br /> ��(, S�'�Lc�1 C'� Te yvi f e houle I <br /> I <br /> I FEE <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 �O` <br /> J � <br /> I hereUy ceRrly thaf I have read and examined this applicafion and kno�v fhe same to be 6ue and <br /> conect All prowsions o(la�vs and oNinances govemmg(his type o/u-ork����ill be complefed — — <br /> whefher specilied herein or not Thc granfing o/a pemut does nof pmsurne to give authonty to PFRh1iT" <br /> vio/ate or cancellhe provi � ns ol any other slafe orlocal I,��v mgulafmg constniclion or the � I� O� - <br /> perforrnance o/consfnrc o Thaf!am authorized by the o��ner o/fhrs property to perlomi fhe � o0 <br /> tv0ik/0�n�hich dpp n s r u�de ond I compty v�dlr the S(afe CenVacfors La�v 18.27 RCW and <br /> 296 200 WAC / / � <br /> ���"��lc� v�� -t� <br /> ��� �- •-e.�`X l S11 l�. <br /> ` igna D ie �- <br /> �e--�M i �' , <br /> , � <br /> ,:cr srn a..,, � <br /> �---- ---- � .. . . _ <br />