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----- -- - � <br /> I' ELECTRI�AL PERMIT APPLICATION <br /> CITY OF E�,'ERE�T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> 5 -�-�3 <br /> , <br /> �-i3�5-o S7 <br /> ;, , � <br /> c,; .' ' Q � 7n� ,�i.c��l� �r/ <br /> PROJECTADDRESS <br /> i �u/i,/�/�S� C��1. S //',.c. / /(�'7 '� D /U L oi,-,b�i.nL� /�.ie t✓�,_.f/ LJ�9` <br /> � Mail Address City State/Zip Phone <br /> Owner <br /> i— �-- <br /> Tenant � Mail Address City State2ip Phone <br /> r— ^ ^ /6 .Z U �/S%� �� ��. <br /> e w. : !i G i""= <br /> Electrica onlraclof A1ail Address <C_a.-,...�,.u�.� City 4� ✓�' Stale/Zip � � ��`�'Phone <br /> - J— �G i S O�- �) <br /> `Stale Licens umber Contract Price of Work <br /> �'"'�" Contact Person (Plan Reviev+) <br /> Proposed Use of Building <br /> Square Footage Qf residential new construclion, remodel or addition) <br /> Number cr(devices Qf low vollage) <br /> I, Descriplion af Work to Be Done: � c � �c>� �^ ' �' � <br /> � <br /> i � - �� <br /> /,�o� :`-� __ 3�?L� , <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /l� �� <br /> 1 hereby certi(y lhat I have read and examined Ibis applicalion and kno�v the same to be frue and <br /> � conec(. All provisions of lavds and ordinances goveming this type o/�vork will be completed <br /> whefherspecified herein ornot The granting ol a pennif does not presume to give authonty to PERMIT# <br /> violate or cancel the provisions o(any ather state or locaf law�egulafing consWcfion or the E � �� 5_o S� <br /> perfoimance ol construction. Tiiat I am aufhorized by lhe o�vnerol this property to pedorm the <br /> �vork/or which application is made and I comply wilh the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �.t S'—� 9! /3 <br /> I --Signature ate <br /> .. .....,,r: . _. _ .. . . _ _.__ __. . _ -. <br /> � <br />