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— ------ ! -- � ---- -� <br /> ; ELECTRICAL PERMIT APPLICATION , <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 47_5-257-8810 - FAX 425-257-8857 — www.everettwa.ory <br /> �� ` ��- �3 � <br /> £�i� ii-lo � <br /> � <br /> 3zo 8 ��n�+���� � Av � � � �3 <br /> PROJECT ADDRESS <br /> y�S z 5�-4405 � <br /> THo�.aAS SNu�-1� �S�-lu�� R�=NRr ) C1 soz3 c�ia�+uen�i u.+v 6� G�3 �o3 <br /> Owner Ma�lAddress � Cny S�ate�Z�p Phone <br /> Ten�� Ma�lAddress Clty Stale2ip Phone <br /> n^� ��;�r �csc i r7r c c:� inrC r�v wa y� z�i 5�zs �sz-v���7 <br /> EleciricalConlractor MadAddmss Clty Slate/Zip Phone <br /> Mc(, �N � Go��� <br /> Slate License Number Contract Price of Work <br /> h C 5 \7:q \Liix <br /> Contact Pe:son Plan Review) <br /> Proposed Use of Bwlding ( <br /> ��1 Ofl X, �- = /(,;c^c`� 1� <br /> Square Footage Q(residential new cons uction, remodei or adddion) <br /> Number o(devices (If low voltage) <br /> DescriptionofWorktoBeDone: N1�1-S,-� -�F(ZV�L�= = Z ' /l� � RMt� �-�Ai7 C�(Jv�r�� W�jf" � <br /> _�'71 ?- CmA-iJc� �.n1-r�,V'L t3A-S�o REw�n.� i�S �Eq�_ c�ec;i � � �3(�S�v�J <br /> tt�.p;� C��c._L�wy wca� p���_�.�ri����_4i�f3�S.u�TS�_— <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 O�� <br /> � <br /> I hemby ceRily that 1 have read and examined Ihis applicafion and know fhe same to be frue and _ <br /> conect. All provisions ollaws and ordinances goveming fhis type ol work will be complefed <br /> whefher specified herein or no(. The gran(inp ol a pemrit does not presurne to give authonty fo pERMIT# <br /> violate or cance/the provisions ol any ofher sfale orlocal law iegulating cons�n�ction or the r ��� � � � �� <br /> pe�fom�ance o�construcfion. Thaf I am �thonzed by the owner n/fhis propeRy fo peAorm fhe C <br /> work lor which applicafion is made and I e. ,�ply�vith the Sfafe Contracfors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> �i�i 1/ ��' ��� 13 <br /> � Signature Date <br /> l� <br /> aE��ctD JRC�O __� <br />