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� • � _ _ _� <br /> ELECTRICAL PERMiT APF'LICl�TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -ww� everethva org G �'��` ) � <br /> � I k�6- 17� i <br /> �i�j� -GVe�P�I IM 1�.1,1 I�GU�1 <br /> PROJECT ADDRESS <br /> � Owner tdad Atlaress Ciry State/Lp 'hone II� <br /> I � 1 1 ,���'�J OL 4�i`K/� W I 1� �YM�I 1/�l VI LU�11 W� � - 1.!)!-l'll� II <br /> ��' <br /> Ter,ant 61a�i Faaress Gry � Sla�- : , Phone <br /> C'LX'`il/l,�,r, 1n LI/1G. 1?l�(i Gt,ukD�-E�t-C�1 �/l �D�'t1lD (�l �tg1�� <br /> Eledncal Con�ractor 1.1ad atldress Cdy StateiLp Pnone <br /> (��C/��a�, O S S J S �(�(� •OD � <br /> State License Number Cc�tract Pnce oi Work I�� <br /> K-V�1 U�.1/�1 \ l�N 1 a'li7 1 I <br /> Proposed Use ot Bu�lding Contact Person (Plan Review) <br /> �jOUb <br /> Square Footage(If residenhal new construcuon, remotlel or addrtion) � <br /> I <br /> I V I <br /> Number ot devices Qf low voltaqe) <br /> Descnption ef Work to Be Done � V l� ` I ��� �V `VV�� �-✓��`� � `-'�` <br /> �� I,vl,f�� - R�IUCfic�-P e(.1�111,OYY�-eV1.-}- . <br /> � <br /> FEE <br /> CITY OF EVERET7 LOCAL SALES TAX CODE IS 3105 1��`-"-' <br /> �/ <br /> I hereby ce�lify thaf 1 huvc read and examined fhis applicrdron and knowlhe same!o be Irue and . I <br /> mrrect All provrsions o/laws antl ordrnances goveming(hrs type n!woik wr116e complefed <br /> �vheL'ie�specdied heiein or nof The granling o/a peimit does nof presume to yive aufhonty fo p[RM[T!. ' <br /> wolafe or r,ancel fhe provisions o/any ofher sfafe or local law regulahng consfruction or fhe I r i <br /> perfomiance o/consfn�r.hon That!am aufhonzed by the ownei o!fhis properiy lo peAomi Ihe E I L-F� � �� � i <br /> woik Iorwh�r,h appl�cation is made and I compl}�with fhe State Con(racfors Law 1827 RCW and � � <br /> 296 200 VVAC • <br /> , , ���/� Y <br /> Signaiure Uate <br /> Ne�:st�,20.�: . ' <br />_ <br />