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� <br /> _. _ <br /> _ _ -- <br /> — <br /> ---� <br /> , <br /> �� ELECTRICAL PERMIT APPLIC�4TIOf� <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 CEDAR STREET, EVERETT, WA 982D1 I <br /> i 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> � <br /> � <br /> ZZ. � �l �..r�.�1_J'�2 V ��J t <br /> PROJECT ADDRESS <br /> i���, II-i41��-N� �-���S�t L 2Z��I �,r�r'lnl.q�/� r1 U� �...�q S�J ��S <br /> � Stale/Zip Phone <br /> I Owne� Mail Address City <br /> � �/ZS-��Zv3o <br /> � Tenant MailAdtlress Ciry State/Zip Phone <br /> �,'�iZ%�/ il���� fcsc;i�u'- iz90y S�� �'U� f� �C'�fi% �� S�T�.(' i�ZT��7�ZZ�7 <br /> 'i Electrical Contraclor MailAddress Ciry State2ip Phone <br /> �J��2%11/�E�'�;�.�5 ��, �N <br /> Stale License Number Conirect Price of Work <br /> �i2t $;���C��S i=- �L- <br /> �i Proposed Use o(Building Contact Person (Plan Review) <br /> , Square Foolage Qf residential new construction,remodel or addition) <br /> Number o(devices Qf low vollage) <br /> Description of Work to Be Done: � -'-�c�r��+�1�c-r �.2� F=: 2 ti �c i C0.(,�4G� <br /> ti�u F�.2,va � t _ . l�c C— <br /> ' I I <br /> F[E <br /> !' CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ���1� <br /> 1 hereby ce�ti/y that 1 have read and examined fhis application nnd kno�v the same to be true and <br /> correct All provisions of la�vs and ortlinm�ces goveming(his type o(�voAc will be complefed <br /> whether speciTed heicin or not The granting ol a pemiit does nof presume to give authonty fo PERMITn <br /> violate orcancel the provisions of any other sWte or/ocal law regulating consfniction orthe ^ I�O n _ �n� <br /> i � peAomiance olconsWction. That 1 am au(hoiized by the o�vner o(this properly to peAorm the C ��� ��� <br /> work(or which applicafion is made and 1 cornply�vilh lhe State Contracrors Law 1817 RCW and <br /> - 296.200 WAC. ,� <br /> i <br /> � <br /> .� `� /B-i� <br /> � Date <br /> Signalure <br /> � <br /> a, ''� � <br />�,f,�'e �ensro�izoin <br /> y�.✓�.. ---- - .___ � - - � - �- - . . ._ <br />^O r , ,�p rvq�4 g V?';,,a..r „�.,.���.n i .,,,.�� �J'� ;�� t� f,} �H�'��� .. <br />�rt":_����..=:;'v(�9� u~.f'�r��S� � I �����9ii�� �I I" .. <br /> _ r_2 <br />