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CLECTRICAL AP - Get PDF.aspx <br />/Iww�v.cvcrcttwa.orJGet_PDP.aspx?pdf1D-35 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERIYIIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />U `i �G- E.rG-�.-6�'�--" M<,--L-�- �1.��' <br />PROJECTADDRESS <br />,l�/�/ .QJ6i,rlSr.-� Soo ia fY�-.c'7r �•tz� k,�fi-7 Eliai rs►- w� S�- �ofl <br />Ownet Ma�i Adtress Crty Sta�e2i0 Phone <br />Tenant <br />Mai� A05'ess <br />�� <br />G�-�� �' S l tT-t 5 <br />'77p`-f NG i'� s `n` <br />Eleclticai COMractor Ma�i nda�ess ���V <br />c_ ��z.. l 5( `a � 3� <br />State Llcense Number <br />r—��� S;�-s,snl <br />Propased Use of Building <br />!zC_,..,wut..� w-� `�8 02�' <br />State2�o Pnone <br />42S-�-tBS.`�Co <br />�$50 � � <br />CoMtacl Price of Work <br />�n.-r f��-�--�'s-��Z'�- <br />Contact Person (Plan Revlew) <br />Square Footage (�f resitlentlal new conslructlon. remodel or additlon) <br />3 L� s� �s �- r���..�— ���-„��- � r-v £� P�,,.,.o <br />Number of devices (If low voltage) <br />Descrlption of Work lo Be Done: Y�^"� ->`�� ud-"'^�^� ti�' �C-: T�+zJ � otiL- L.-6 C� <br />� ' <br />l o O � o w�.c LL lTd-T rU (i 7 5 2 r.o Q1-u- U""- �- c�-"'`"T <br />CITY OF EVEREIT LOCAL SALES TAX CODE iS 9105 <br />! hereby ceRdy fhal I have read and examme0 fhrs appGcahon and know U�e same fo be fine and <br />co/rect All provisions ollaws nnd ordinancos govemmg fhis type ol �vo�k will Ao <:ompleted <br />whelher speafied hercin or not. The granting o7 a permit does nof presume ro give authonty to <br />violale or cancel lhe provisions oJ any ofher sfate or locaf law regulating consductron or (he <br />pedortnance ol construction. That 1 om aulhonzed by the owner ol fhis p�opeAy fo peAorm the <br />work lor wAich applrcation is made and I compp� wrth the Stafe Contractors Law 18.27 RCW and <br />296 200 WAC <br />3r�.-s� � 3 <br />acvicrn �v�i� <br />FEE <br />500� <br />PERMITlt <br />EI3D3-Ib2 <br />,oy <br />J/2S/2OIJ II:IJ A��i <br />I of i <br />