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-:R <br /> � -__ • __ <br /> �' -___. � <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 �_ �_�U <br /> Li�o �f� ar� <br /> � ;-2 � LO'�'1 g� �4✓� - <br /> , PROJECTADDRESS 7�— 9�� <br /> I�.f1.viN NEG��A+��2 /Sz� Gan�� �� (,��9 qf�zo/ -��6 <br /> C�:�ner Mai�Address C�ty State/Lp Phone <br /> ��� State/Zi Phone <br /> Tenanl Mail Address Ci�y P <br /> y2s'-a�9- <br /> F�C�� f�Fcr��c /y�d a� x�� ���r�19'g�� �6d� <br /> Cd State/Zip Pnone <br /> Eleclrical Coniraclor 61ai1 Address Y <br /> :�/,Qsr�c�97/�� <br /> �Gf70 s <br /> Slate License Number Conlract Price of Work <br /> s� j'�7r i��n5 <br /> I n <br /> Proposed Use of Buiiding Contact Person (Plan Reviev�) <br /> N/�7 <br /> Square Footage Qf residential new consiruction, remodel or addition) <br /> N�A <br /> Number of devices Qf low voltage) <br /> Description of Work to Be Done: � ��m� ' " � �� C/�CU/� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �O�f <br /> I hereby ceRily Ihaf I have read and examined this applicafion and know the same to be We and _ <br /> cor�ect. All provisions o(/aws and ordinances goveming fhis type of wo�lc�vil!be complefed <br /> whether speci�ed herein or not. The granling oI a permif does not presume to grve authonty ro PERMIT# <br /> violate or cancel the provisions oI any other sfafe or local!aw regula�ing caistrucfion or the � I r , r,�� ��I� <br /> performance ol constn�ction That 1 arn aufhonzed by the ownero/lhrs propeRy to pedorm(he �f�� 1 <br /> work Ior which applicafion is made and 1 comply ivi(h fhe State Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �i�'� y �A � <br /> aWre aie <br /> REViSED7RGit] __--- . _- <br />