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� <br />� <br />E�.ECTR��AL P��MIT' �►F��'��CA�'9C�i� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - �w✓v✓.everettwa.org <br />�9 Si o� ��-� �� - <br />PROJECT ADDRESS <br />�/ "^ <br />Oamer <br />Tenant <br />/� CC� !' S�, w�e <br />Mail Address <br />tvlailACdress <br />/i/r v � � ��l/� fi <br />EleclricalCoMractur F.ta�lAdaress <br />>�sr sw <br />/�/�-� �> C � 73 �� /�/� <br />State License Number <br />Proposed Use of Building <br />Square Footage Q( residenlial nev� conslruction, remodel or addition) <br />Gty <br />Cdy <br />=�[v�� wC' <br />City — <br />StatelZip <br />Phone <br />Slate/Lp Phcne <br />.:�n • <br />� . /��� � 7/ y�% �5 <br />Slate/Zip <br />S`�Z� J u <br />Conlract Pnce of Work <br />Contact Person (Plan Review) <br />Phone <br />Number of devices Qf low volla9e) <br />DesciiptionofWorkloBeDone: �l�L�`Y�<<i' /�1����'��e�"� _ -------- <br />CITY OF EVERETT LOCAI SALES TAX CODE IS 9105 <br />I he�eby ceddy thaf I have read and examined fhis applicafion and know Ihe same fo be lruc and <br />cormcL A�l provisions olla�vs and ordinances yoveming fhis type ol ivork �iB be completed <br />�.vhe(her specilied heiein or no!. 7he 9ranfing ol a pe�mit does not presume fo give auU�onty to <br />wnlate or canral fhe provisi,ns o/ any ofher stale orlocallav✓ iegulafing consfrucfion or (he <br />perlormance o/consfrucLon. T/iaf I am aufhonzed by fhe on�ner oI N�is p�opeAy (o perlorm Ihe <br />work for rihich applica�ion is made and I comply wdh fhe Slate Con(iactors La�v 18.27 RCV✓ and <br />296 200 WAC. <br />����% % ,/� <br />Dn� fi% �.'.�/���' " / i / ol /�% <br />FEE <br />�U�� <br />P[RMIT:. <br />E c�Fos- or3 <br />