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� � <br /> - - - ---- ___- --- -- - - - - <br /> i <br /> �� ELECTRICAL PERMIT �PPLd�A�'iC�f� <br /> I CITY OF EVERETT PERMIT SERVIGES i <br /> i 3200 CEDAR STREET, EVERETT, WA 98201 i <br /> 425-257-8810 - FAX 425-257-8857 —www.evereU!va.org i <br /> I � <br /> � S� � R <br /> � I. ; <br /> , �; s_,� r- ��� �.�Jr u,�� ; <br /> � PROJECTADDRESS � <br /> I <br /> I <br /> � Cv+ner F.fadAddress Gry State/Z:p Phone � <br /> I I <br /> �},��- ,�141�c1.5 y1s- zs�-�ss-US` � <br /> Tenant IAadAddress Gty SlatelZ�p Phane � <br /> � n /� I <br /> ' 1�ilra i,n� ��l�c`�'r��'a1. 4�n„z�s nv� z�5'� ��c..,t�'�Y `(�.((s 97�z5 z <br /> ElecLic I� "�1aJAadress Cdy StatelZ�p Phone <br /> I ' <br /> ; �1 la��,�� 9s� �i-I ��� � <br /> � Sta�cense Number Conlract Price of Work � <br /> Contact Person (Plan Revievq I <br /> I Proposed Use of Butlding ' <br /> � <br /> I Square Footage pi residential new conslruclion, remodel or addition) � <br /> I ' <br /> � I <br /> ' Number ot devices(If low vo�tage) <br /> � Cescnption of Work lo Be Done: f�I�I � L ��l� ���) ��S. v�� �"`""c � ` �� n�•5 � <br /> � /� II^', � <br /> � � � l �,/Lle, l_�7_C��'_� - i <br /> I � <br /> I <br /> i j <br /> I' FEE <br /> I CITY OF EVERETT LOCAL SAL[5 TAX CODE IS 3105 / � j <br /> � 1 •. � � <br /> II hereby cedity thaf I have read and examined fhis applrcafion and knmv the same fo be 6ue and � � <br /> conecf All provismns olla�vs and orAinances goveming fhis type ol work will be complefed I <br /> � �•�hefher specdied hemin ornot The granfing ol a permit does nof p�esome 7o give aufhonty fo PERh1ITx I <br /> i violale or cancel Ihe provisions ol any ofher sfafe or/ocallaw regul�Gng consfNctron orthe <br /> � perlormance oI construction. That I am aulhonzeJ by Ihe owner ollhis property(o pedorm the E � �Q �j _ O ( � I <br /> ,�ork lor�vhich application is mede and 1 comp/y wdh fhe Stale Conhaclors La�v 78.27 RC W and _ � <br /> I296 200 WAC I <br /> ! �;�1.�����---�-- --_�/�-// � <br /> S�ona!wc Dale <br />