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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES cc�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � ��-9��71 I <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org � I y�� ���{� <br /> I d �� �.r�zcr� rn A�--�-.. �,..�A� <br /> PROJECT ADDRESS <br /> Owner Mail Address C� Stale/Zip Phone <br /> 'T� (��' �c� —T��S � 42�—si z� �' <br /> Tenant MailAddress City StatelZip Q'J+�.�I� Phone <br /> /C�E✓•�i <br /> 1�2flss t N ���-1c�- C° � PO �'-���x �i�lC� ��.�rr y z�33 �� <br /> El�cal Cont�actor Mail Addiess Cdy Stale2ip Phone � <br /> }�'(L��55 �c`�11 �-r ���v <br /> Slate License Number Conlract Price of Work <br /> s�.—r r� c L �F' f�C�= <br /> Proposed Use of�uilding Contact Person (Plan Review) <br /> Square Pootage Qt residential ne�v conslruction, remodel or addi�ion) <br /> Number o(devices !II low vollac�e) <br /> Descriplion ol Work lo �e Dane 1`��-+��1� �rZ '— �x� ; �!�� 1 — L" I��� <br /> T_�_Z�__.l�T_���-�_�_�� � M �_ �)��� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS a105 r^ q,5 � <br /> Y� l <br /> 1 hereby certily fhaf I have rnad and examined this application and know Ihe same fo be frue and _ _ <br /> cortecf. �II provisions ollaws and ordinances goveming this type oI work will be compleled - <br /> whethcr specdied hcicin ornoL The,qranling ol a pernnf docs nof presume�o give authonty to P RM[T!t <br /> violatc or cancr.l thc pmvisions oI any othcrsfalc or local la�v rc�ulaling r.onstrucfion or fhe � I �� � J I�� <br /> pe�lom���nce ol consfn�cfion. Thal I am aufhonted by Ihe owner ol lhis prope�dy fo per/orm fhe <br /> work lor v�hich a �Aca(io is made and!compty wdh(he Sfafe Confrac fors Law 1 8.2 7 R C W an d _ <br /> 2�6.Z�� w�C � <br /> �f� / /��� <br /> .--. <br /> � Si9natum Dale <br /> BCL'�51 U Vi'NI] <br />