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ELECTRICAL PERMIY APPLICAYION <br /> CITY OF EVERET7 PERMIT SERVICES <br /> 3200 CEDr^.R STREFT, EVERETT, WA 98201 <br /> 425-257-8810 - FAX ��S-257-885- -wvv�v.everettwa.org <br /> 7_f0�l3 <br /> C-r-�o�-03'7 <br /> �C� S� �'U A� Z� �`� W P��.> <br /> PROJECT ADDRESS <br /> Y�1N��c �5'f1't�1� 33�� OPK��s ��'cNv,�, �c,o-���, �;A ����I <br /> Owner MailAddress Cily State/Zip Phone <br /> Tenanl Mail Address City SfalelZip Phone <br /> (�(11.95'��1 ��P��Cc��_ �� LI.G ��'� Qi2c�� �i�Ar� �V� �'rFhzl7�o �'��� 33g—���il <br /> Electrical CoNraclor Mail Address Ciry State/Zip Phone <br /> C�__�_ <br /> �GZr�Ss EC g��l `1 �G' _ ,� 00 <br /> Stale License Number Centracl Price of�Nork <br /> h��=j (rE c � � <br /> Proposed Use of uilding Contact Person (Plan Review) <br /> Square Foetage Qf residential new construclion, remodel or addition) <br /> Number ot devices(If low voltage) <br /> Description of Work to Be Done: �Po�Y=( Ci �" Ou��O� � ��1�. (� � 1Rh�X <br />-. <br /> i FEE <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I , � �� <br /> I hereby certi/y fhnt I have read and examined this applicafion mid knoir tha same fo be tn�e and <br /> l( <br /> coriecL A9 provisions o(laws and ortiinances goveming this type o/�vurlc will be completed <br /> I whether s>eri(ied herein ornoL The gr�nting o/a pemiit does not presumo fo give authonly to PERMIT# <br /> ' 'olate o cancel the provisions ol any ofhersfa(e orlocal law�egidating constn�ction or the <br /> perfonnance o/constiuction. Thaf I am authoiized by tlie oemer ol this properfy to perform the � 1 ���� — � � /' <br /> work/or which opplicafion is made and 1 comply wifh the State Con6ac(ors Law 18.27 RC W and <br /> - 296.200 WAC. , � <br /> ��� .\�, �1 � 10 ' I � <br /> Si naWr ` Date <br /> I ;:, _.�.;.,,,�:��» -- <br />