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---� <br /> ELECTRICAL P�RMIT API-'!��ATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � .�n�y <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> C- l 3 �Z--aa � <br /> i(3o s� ���-� �� (( u�,�t y /� n n <br /> PROJECT ADDRESS ��O �� ( �Q�Z�t��'�""T �`�`� <br /> SS ��� ( �`� �at ����f�s L �C C� K�o�� . Off �-f�F 70� <br /> Owne� Mail Atltlress Ciry Slate2ip Phone <br /> �A��! E �� i fi� ��r 7/r\ �1� ��/�i✓s'r E"(( �dl� � I.l��'/f �If6f"��,l�� /C>ZOg <br /> Tenant �- Mail�ddmss Ciry Stale2ip � Phone <br /> C����s�qN � 1k,�.�; �,� �o aa� e�� 1.�= ��- 98�9 360 ��3 �a�o <br /> Electrical Conlracto� Mail Address :,iry State2ip Phone <br /> C�lP �7sfl 873 �,� ,�3�0 <br /> State License Number CoMrad Pnce of Work <br /> CO M�iFVGI� <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Square Footage pf residenGal new construdion, remodel or adddion) <br /> G <br /> Number of devi��s Qf low voltage) <br /> Description of Work to Be Done. ��Pl�� �' / � � �� �� �1\`�� �GI �(aT <br /> t <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 }�)7! �Y1� <br /> I heieby certdy llref I have rtraU anU examined Oiis applica6nn and know�he sarne(o br.(iuc and _ `�v v <br /> corrr,cG All pmvisions o/faws and ordinanr,n,s govemin,y fhis type ol work will br.compleled -- — <br /> whefhr.i spccrleJ hcrcrn or noG The gronlmg ola permlf does not piesume to grve aufhonty lo PERMiT# � <br /> violate or cancel thr.provisions ol any ofhr.r sfate or lor.al law regulafing r.onstn�clion or Ihe ^ { J� � ' O� � <br /> peAorrnance o/ccnsfn�r.tion. Thaf I am aulhonzed by the o�vner nl tbis propeAy lo pedorm(he t I <br /> work lor wl�ich application is made and I compty wiU�fhe Stale Confracfors Law 18.27 RCW antl _____ _ _ _ <br /> 296 200 WAC. <br /> II 2 � (3 <br /> Signalurr Da�e <br /> utwsFn vton� <br />