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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —wnvw.everettwa.org � � ..a,�f,, �3 <br /> �1�17����1 <br /> �b��s I��KoT w.Y <br /> PROJECT ADDRESS <br /> (,pNDA �Eu�►S /oILS QAK�f+ W.y ��E��WA. q�°y Y2.S- 2'►o-59yo <br /> Owner Mail Address City SlalelLp Phone <br /> Tenan� Mail�ddmss City Stale/Zip Phonc <br /> �uN�An►cE. ��� S�►cES lou� �.�wrN � ��+�w� _ 98ai �/zs-�8r-��6o <br /> Electrical Conlraclor Mail Address City StalelZip Phone <br /> J'u lJ �A�S O� ZSQi � 0 0 <br /> State License Number Contracl Price of Work <br /> S�2- <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Square Footage(If residenlial new conslruction, remodel or addition) <br /> Numb�r of devices(If low voltage) <br /> Descriplion ol Work lo Be D�nc: �N�A���� A N�L✓ G�IwV�T(CU�— A U f�«�Sf <br /> W�-r-Pv��,p <br /> FEE <br /> CITY UF EVERETT LOCAL SAIES TAX CODE IS 3105 V7 U� <br /> ✓ <br /> 1 hereby certily fhat I have rcad and examined this applicafion and know!he same to be(rue and <br /> correcf. All pmvisions ollaws and ordinances goveming ffiis fype ol work will be complefed <br /> whether specificd herein ornof. The granfing o/a permif does not p�esume fo give aufhonty fo PERMIT/1 <br /> violafe or cancel fhe prnvisions o/any ofher stafe or Iocal law regulafing consfrucfion or the E l �1 z- I 5� <br /> peAomiance o/consfn�c7ion. Thaf I am aufhonzed by fhe ownerol fhis property to pedomi!he <br /> work lor which a fication is made and 1 comply wi11r!he Sfate Confn.cfors Law 78.27 RCW and <br /> 296.200 WAC. <br /> � <br /> (1r -Z3-1 3 <br /> Sig ture ����� <br /> ur visEo 1^an� <br />