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- --�---- -- ----� <br /> � <br /> ELECTRICAL PERMIT APPLICATION i <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98207 � <br /> I <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> i <br /> � <br /> �3�-0 ������L�i�-V�, y,zs � <br /> I PROJECT ADORESS �� - <br /> ' L � _. Qr�f2 �a �L U�{2�,�1�( 1 N ,��_�� i <br /> Owner Stad Atldress Gty Stale2p Phone i <br /> I <br /> � Tenant Mail AdAress Ciry Slate�ZiD � n Pnonc , <br /> ' .���sxJ lo� ao� � y�� �� 9�.� ����� <br /> � � � <br /> �I EleclnCal Cenlractor Ddad Atltlress Ciry SlatelLp Pnone <br /> , ��'�h-/�S�S/'�-�L� �sa � I <br /> � Stale License Number Contrect Pnce of Work <br /> I I <br /> ���l� Il .F— � l <br /> Proposed Use of Bwldmg Conlact Person (Plan Rewew) I <br /> i <br /> Square Foolage(II resitlendal new construct�on, remodel or addihon) I <br /> I <br /> Number of devices pf low voltage) ,� <br /> -�Z�"-�i/r�� O v�' � s ��� �i�c,�/� �s ' <br /> Descnpdon of Wark to Be Done L( /�_[�____ I <br /> .�.�4_1/l — ('o�U 0(//�, (.cl.l I/l c�' �V G- _ <br /> ; <br /> � <br /> FEE ' <br /> CIiY OF EVERETT LOCAL SALES TAX CODE IS 3105 S� ^ <br /> 1 hem�y certity Ihat I have read and exammedlhis appbcahon nnd Nrrow fhe same fo 6e Irue and _ ___. ___ i <br /> Iconecf. All p�ovisions o!laws and ortlinanres goveming fhis fype o/woik will Ge enmplr,fed � <br /> whether spcciled herdrr or not The granfmg ol a pemut docs nol pn;sume to give authanty to PERMITlt I <br /> wolate or cancel fbe provisions o(any o(her sWfe or local l�w regulafmg consduction or the <br /> IpeAorrnance oI consfn�ction. Thaf I am aufhonzed by the owner o/fhis property fo peAonn Ihe E � L+ D(— �$ I <br /> wodc loi which plrcaGon�s made and 1 compty wdb fhe Slate Confraclors Law 18.27 RC W and <br /> I296 200 WAC ! <br /> i / 3 / � <br /> �qnaNre �ate I <br /> 'I /c .,�.�:p t.J,•� i <br /> l—!'__—__--_ _—__—____. _— ' ___—'__ . __ ___".—_ " .- — __. ".._'__—_.. . . _ —. _" __ _ _J <br />