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- - ----- ------ - - 1 <br /> ELECTRICAL PERMIT APPLICATION I <br /> CITY QF EVERETT PERMIT SERVICES � <br /> I 3200 CEDAR STREET, EVERETT, VJA 98201 I <br /> 425-257-8810 - FAX425-257-8857 -www.everettwa.org -3..a���3 I <br /> I ��3o3-S�j � <br /> ��. � , � <br /> �, i�, � r<, <br /> PROJECT ADDRESS <br /> �"l�h� ) � � �� ,�-.1�-� �r� � ��1�� �' l.J � C7 �d 0 � <br /> Owne� Mad Address ��� <br /> Y State/Zip Phone <br /> TenaM Mail Address Ciry Stale/Zip Phcne <br /> � ! �3�Zo �f�S :�,�3��y-� -� <br /> ./ItC'vf�f?- � ��c �"ViC � �1 �'c � �v1��'lniM �s �n l�._1 � ���`� o <br /> Elec�ncal Contraclor Mail Address Cit <br /> Y Sla:e/Zip Phone <br /> �L� � � r�5 �f�S � L - --�Z 1 ��,� , ou <br /> State License Number Contract�rice of Work <br /> � � � <br /> Proposed Use of Bwlding Contact Person (Plan Review) I <br /> ISquare Footage(If r�dential new construction, remodel or addition) I <br /> i <br /> ��1 �c'_ <br /> Number of devices Qf low voltage) <br /> Uescription of Wark to Be Done: G i L� � / � ( � � �^� �. — <br /> i I <br /> I I _ <br /> FEE <br />� CITY OF EYERETT LOCAL SALES TAX CODE IS 3105 [ ��C <br /> �..1 — <br /> I hereby certi(y that I have m.ad and examined(his applrcation and know the same to be tnie and <br /> correcf. All provisiens cf/a�vs and ordinances goveming(his type of wodc will be cample(ed <br /> �rhelher speci�ied herein or noL The granting o/a peimit does not presume to give authonty to PERMIT« <br /> violate orcancel tlic•provisions ol any o(herstafe orlocal la�v mgu/ating cons(ruction or Ihe ` �� <br /> perfomiance o(construcfion. That I am aufhonzed by fhe ownero/this propeRy to perfonn the E � ��3 <br /> �vork/or�vhich application is made and I comply wiNr(he State Contractors La�v 18.27 RCW and <br /> 296.200 WgC�4 � <br /> ( / Sign ttlL'(�� "-- � / e/ �' (�b�CL�� <br /> � ,_ .._.._._ n I <br /> ,��...:,�,._, I <br /> �- - -- - - -.___.. - -- -------- ------ J <br /> . <br />