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s - -- <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www everettwa org <br />� <br />I S � o� all I..� ��,u�f` I,.�A g8 Zo� <br />j PROJECT ADDRESS <br />Owrer <br />; M���ae S <br />Tenant <br />Mail Address <br />'Ja�l Address <br />n_d /�,�n G � <br />Eleclncal Centractor �aar. Atldress <br />/����'�' /`j��'(L <br />iStale License Number <br />� C,o rn nn <br />� Proposed Use of Bu�iding <br />Square Footage pf residenlia� new construction, remodel or adddion) <br />Number ol devices Qf low valtage) <br />, <br />Descnption of Work to Be Done: <br />r <br />CJy <br />Gty <br />Cdy <br />� <br />State/Zip <br />Slale2�p <br />Slale/Z�p <br />-- � <br />Phcne <br />�hone <br />Phore <br />CcnGact Pnce of V�brk <br />J-osll 2s3 �81 �(oU <br />Contacl Person (Pian Revie•.v) <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 `���V <br />� � <br />I heieby rerti/y U�af 1 have mad and exanrmed this spplicafion and knoiv fhe same fo be (rue and ___.__ <br />wnecl All provisions olla�vs and o�dmances goveming (hrs fype ol n�ork wdi 6e completed <br />whelher speci(ed hereir or noL The granfing ol a pennrf does nol presume to �ive aufhonty fo PERMITk <br />violafe or cancel fhr. provisions oI any other sfale o� local la�v regulating construcGon or the ��� O� `O �� <br />peAormance o! cons�ruc(ion That / am aufhonzed by the owner ol Ihis propeRy (o peAorm fhe <br />work �or whicir application rs made and 1 comply wr(h the Stafe Conlracfers Caw 18.27 RCN'and <br />296.200 WAC <br />YV�a.tl P�cl i n <br />rz�,,s<o ���-,� <br />