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-- -, --� <br /> ELECTRICAL PERMIT �4PPL.ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � `aO�I y <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> C ► �og -1l7 <br /> ��j� ��i� ST <br /> PROJECT ADDRESS <br /> G/�/S- G��yl 5T EvPr� rT CJ�- <br /> Ovrner MailAddress City StatelZip Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> �{zs=7�z-7z 6 <br /> ��9�av2 Pain�f EC��T�rC lo9ZS /6S7`' S'r Sc,,� ��n%�r,�oD..� �✓.� 9863% <br /> ElectricalContraclor MailAddress City State2ip Phone <br /> �/A�.6�n� y Qp G 3 I � i s' <br /> State Licensa Number (required) City o(Everell Eiusiness License Number(required) <br /> �� �IJ J). b!7 <br /> Proposed Use o(Building CoMract Price of Work <br /> � ST�.� o�����o� yzs�y�i-oyoi <br /> Square Foolage Qf residenli new construction, temodel or addition) Contact Person/Contact NumbedEmail <br /> IG <br /> Number of devices Qf low voltage) <br /> Description of Wo�k to [3e Done� /�j' D D /� m0 SPQ v�G e �/��6� <br /> FEE <br /> CITY OF EVEftETT LOCAL SALES TAX CODE IS 3105 ���� <br /> I limeby caidy flraf!have read and examined fhis applicaGon and kno�v the same fo be true and <br /> correcL All provisions ollaws and ordinances gavemin�Ihis type ol wmic wdl Ue cornple(ed --- <br /> �.hclher spedlied hercin o�nol. The granling ol a pemuf does nof preswne fo give au(honry ro PERMITlt <br /> viola(r, nr cancel fhe provis.nns ol any ofl�er stafe or local la�v rr.gula(ing canstruclion or fhe E ( ,�b �_� � .7 <br /> pedormance o!cons(rucfion. That I am a�,�no�;Z��r,y u��o��„��o�rn�s��,o���ry�o�,�,ro�,,,rn� <br /> �vorklorwhicli apU��cafiai is madc and 1 r.omply wdh fhr, S�afe Conhacfors La�v 18.27 RCW and ______ <br /> 296.200 WA . <br /> - ����,�, _ �-z o - i� <br /> ,,, <br /> Signalurc Dale , <br /> rr v�;�n„A.�,.�:nru <br />