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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 •—/z .—/� <br /> 425-257-8810 - FA:< 425-257-8857 —www.everetlwa.org L�� ,�� .3 �D�7 , <br /> A �A � O� ' <br /> � -�� ����,�� - <br /> PROJECT ADDRESS � <br /> .��171f � ����r(il �llc���L �l�L'!"�� Phone <br /> Mail Address City Stale2ip <br /> Owne� I <br /> Tenanl <br /> Mai!Address City Slele!Zip Phone <br /> Electrical Contractor Mail Address <br /> Ciry State2ip Phone <br /> I1�I71 f'�P�'TN CoNracl P�ice uf'vJork <br /> Stale License Number <br /> �r1��E� � ( � �"-'/' Contacl Person (Plan Review) <br /> Proposed Use of Building <br /> ��Ci� I <br /> Square Foolage Qf residential new construchon, remodel or addi6on) <br /> Number of devices(I(low voltage) <br />- Description of Work lo Be Done: <br /> �ie�J�H7e �DUj} 1?9rfU^ .l1�>Sz G1 �14/7_T�n GU/�t/�Q <br /> �- , � � z,;�3 - ��. <br /> —(-t; _Z�- <br /> I, <br /> FEE <br /> ' �U�� c:•��Ir -frc�:lt -P t'S <br /> � i CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I �Lc� <br /> l l�ereby cerfily that 1 have read and examined fhis application and kno�v fhe same to 6e hue and <br /> Icorrect. All piovisions o(la�vs and ordinai�ces goveming(f�is type of�vork�vill be complefed <br /> Iwhetherspeci�ed herein ornot. The granting ola pemiit does notpresome to gii�e authonty to PERMIT# <br /> violafe or cancel!he provisions ol any otherstate orlocal iaw�agulating consWction orfhe .� --� —�7 <br /> Iperlonnance oI consWction. That 1 am aufhonzed by the o�vnero(this prop.ity to peiform the E r .-�� -� C' ( / <br /> work for which application is made and I compty with the Stafe Confractors Law 18.27 RCW and <br /> � 296.200 WAC. <br /> � y�(� � <br /> ignaWre a e <br /> raev�srnvsau --- —— <br />