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� � <br /> - - -- - — --------------_ _ _ - -- --__ _ - ---- - — <br /> i i <br /> ', ELECTRICAL PERMIT APPLICATION ; <br /> j CITY OF EVEkETT PERMIT SERVICES I <br /> i 3200 C[DAR STREET, EVERETT, WA 98201 � <br /> � �125-257-8610 - FAX 425-257-8857 —www everettwa.org I <br /> � � <br /> i � <br /> ; 6�"C�s c y�r�sS s� <br /> I PROJECTADDRESS yZ-�r, <br /> ', Lrr�d� c<l��s �S�oSGyO►-as s� Ev�c�e� w�I g8�� 32ZSTil ' <br /> O�vner �da�iAtldress C��y s�ate2�p Pnone <br /> '�, Tenanl MadAddress City State2�p Phone � <br /> � Q�c� � �� l c��ri� plus S72y /Y7 tJ�P�ii= G��'r 5�G�P�n i��.A �4�ZS� 35Y G31� , <br /> ElectncalCo .ractor tAadAddress Gty State!Z�p Pi,one <br /> '�� �P�Iy7Q � �P ����`� <br /> � State License Number ConUad Price ot Work . <br /> � sr-,,� �� l� d�l��P� , <br /> Proposed Use o(Bwldmg CoNact Person (Plan Rewew) <br /> I .�uare Foolage pf residential new cons�rudion, remodel or addiUon) ; <br /> i <br /> Num6er of dev�ces (If low voltage) <br /> IDescnption o(Woik to De Done: ,� '/� � �� /`vC���U��^�( Or� " ! . <br /> � / f � <br /> � ��l � �,l4�1 � ��I S'/iC? -- i <br /> � � i <br /> i <br /> � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 5D - O� <br /> I hereby certdy lhat I have mad and examined fhis application ardlcno�•�the same(o be tnfe and <br /> conecf. �11 provisions olla�vs and ordinances goveming fhis fype ol n�oric�vdl be cornpleled <br /> �:hefher specilied herein or not The granling o/a pemut does no1 presume fo give au(honty to pERMIT� <br /> vrolate or cancel the provisions ol any othersfate orlocalla�v mgula(ing construchon or the � ( <br /> pedormance ol constn,ction. Thaf I am autho�zed hy the owner of this property to perfomi the E � �U "l� " � �� <br /> vo�k!or�vhrch apphcalion is made and 1 cornply�vith(he Sfafe Conl�acfors Law 78.27 RCW and <br /> 296 200 WAC. <br /> �� __�=__�-�C�� y. zy. �3 <br /> . Sgnawre Date <br /> � r.eus�n�r.o„� --- -- <br />