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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIC;ES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> Yq�3 De/4�..�„� .�ve <br /> IPROJECT ADDRESS I <br /> i L�a9—F4��een Sa�te. E��' ! <br /> Owner hlad O ldress City SlatelZ�p Phone <br /> � <br /> � I <br /> Tenanl �tailAddmss City Statc/Lp Phone <br /> �d��1�{��G 37.Z� 188�`Sl•N6 �9� •�- wL9se3�3 4�.tf a��— � <br /> ElecVical Contractor L1a�!Address City State2ip Phore i <br /> �REI.� � a� 991D� <br /> iSlate License Number Contract Price of Work <br /> ' Residw,�; � � <br /> iProposed Use oi f3uiidiny Contact Person (Plan Reviev+) <br /> � ��D S�� D � � �� -a?9dor>�,l , <br /> Square F otage Iif residenhal new construction, remodel or add lion) <br /> I i <br /> INumber af devices (If loe�vcltage) <br /> IDescription of\Nork to �e Done'. (J�l rQ�Qtv�_4.Mq�¢ 4 e` W�/'��71$1;�1.1z�e..'g,L, _ <br /> Itle��c4fe__�J.e!"✓�`�� --- -- --- ' <br /> I ------- --- � <br /> FLL <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � /'1 vo <br /> I Irereby certily fhat 1 have read and examined(his applicafion and kno�v the same fo be lrue and V J <br /> cormct. All provisions olla�vs and ortiinances goveming fhis type ol vmrk will Ue complefed <br /> �vhcther specified herrin or not The gr.�nling ol a pemrif does not pmsmne to give authonty fo pERh11Tr <br /> viola(e orcancel lhe provisions o/any othersfate orlocallaw regulafing construcrion orfhe <br /> perlonnance of r.onsWclion. Tlrat 1 arn authonzed by fhe o�vner�l fhis property Iv peAom�fhe E � 30C� - I � B <br /> �vo�k Ior�vhich applicatron is made and I compty wdh the Sfate Contracfors La�v 18.27 RCW and <br /> 296 Z00 WAC. <br /> �. � �^-- �—��— /3 <br /> Sig ture Oate <br /> PFt�StU VNU <br />