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� � <br /> r . I <br /> i <br /> ELECYRICAL PERMIT APPLICATION � <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everetlwa.org <br /> �/S'/2-R�� <br /> � lP 0( ��YY1 r.�r C1 Q ll-t_ 1� -�-/� <br /> PROJECT ADDRESS <br /> y� , c.�a.� I v o�� IcL�I ��-- a o� . q .�3 � �-�,�3 <br /> Owner �daJ Atldress Clry State2ip Phone <br /> Tenant Mail Adtlre�. Cuy S�ateiZ�p vnone <br /> Qc c.wv�A.+� L�IA-�rv� �I l. �! g 13`�'�' l�l- �paJ-�l-� l.�)o- 9 '81 le8 ,�pto a�) B �� <br /> Electncal Contracror M3�1 A(1tlreg5 Clry StatNZlp Phone <br /> �ww�o.� ��d D.� oa a�3 0 <br /> State License Number(required) Ciry of Everett Business Llcense Number (requiretl) <br /> � �F 2 _ � 3bo <br /> Propo;ed Use of Building Contrect Pnce of Work <br /> j „�,,� r�� �3r�� <br /> Square Footage (Ii res�dential new consWction, remodel or addition) Gontact Pcrson/Contact NumbedEmail • y�/� <br /> ao� . a � � � ��► �o <br /> Number of devices Qf low voltaqe) <br /> OescripUon of Work to Be Done: �� Ct.��a s i�V ✓ Vt.�t <�- <br /> � <br /> FEE <br /> CI7Y OF EVERETT �OCAL SAL[S TAX CODE IS 7105 rOl.(J <br /> I hereby certily Ihaf 1 have�ead and exomined this applicetion and know the some fo be lrue and '� <br /> rorrecL Flll prowmons ollaa�s and oNmanGCg gOveming fhi5 fype 0(w0/k wtll6r, cOmp�efod <br /> whether specified herein or nof. The grantinq o(a permif does nof piesume fo pive aufhonty fo PERMI7# <br /> � violate or CanCe!the prOviSions o(any other sla}e or lor.al lav�rogulating consfructian or the I /� <br /> peAo�manca o(cons7ruCflon. ThBt/am au(hoiized by the owner ol this p�operty to peAorm Ihe E I q-I Z�w� <br /> wark Jo�which epAliCn�iO��c mnde s�d I compty wilh fhe Stsfe Confr�ctais Caw 78.27 RCW and <br /> .9 .200 wAC. <br /> � � � <br /> Sfc�natum � oa e <br /> ��v�[Fr pry95?ct! <br />