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i - � <br /> ELECTRICt'�L PERMIT APPLICATION I, <br /> CITY OF EVERETT PERMIT SERVICE� I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org � �i <br /> - a9-�� _ <br /> ��� y_�%3 '� <br /> �I <br /> � � � � i-�� U�g ��� ���r��t �a- <br /> PROJECT ADDRESS - li <br /> ' I� -���� �� I-I T����„�, � �d7 {�t�.��-v���1� �� I,J�, _ i <br /> Owner Mail Address City State/Zip Phone I <br /> Tenant h9ail Address City SlatelZip J��� Phone I <br /> `{7 ' ( r �i. �.��.�y�'�p'( ��J� �CJ�Y,�(! 3/�D'C� I <br /> `�Y\c\;\S � I�C�YIL�f�C.- �$-IIIA �'� (�U.� <br /> Electrical CoMractor Mail Address City SlatelZip Phone <br /> I <br /> � p yy ' _ ', <br /> p O � <br /> �����—�D�-.�I 11� Y.:,1� 1 fVI�', �- ,L-' i���� �";�j Conirac�ri�ofWork �� <br /> State License Number <br /> 1� � �� e' Contact Person (Plan Review) I <br /> Proposed Use of Building I <br /> I. _�+'�i', <br /> ! Square Footage Qf residenlial new construcUon, remodel or addilion) <br /> INumber o(devices Q(low voltage) <br /> Description of Work to Be Done: l J � 1�� r � I ���G' �Q � ��'� � <br /> I <br /> I C L 1 . I <br /> i ; <br /> FEE <br /> I� <br /> I <br /> �� CITY OF EVERETT La�CAL SALES TAX CODE IS 3105 �`'�_ �� I <br /> / <br /> � I hereby ceitily that I have rcad and examined this application and knew the same fo be true and , <br /> con�ecf. All provisions of Imvs anJ orclinances goveming this type ol work�vill be completed <br /> r:helherspecified herein ornoL The g�anfing ol a pemiit does not presume to give aufhoiity lo PERMIT# <br /> �� violafeorcancellhep��visionso(anyothersfateorlocalla�viegulafingconsWcfionortHe � . �I _ / -�L I <br /> I� I perlonnance o/construc(ion. Tlial 1 am autho�ized by fhe owner of fhis propeRy to perfonn Uie E ( --(- 1 � <br /> �zork lor ivhich applicalion is made mid I comply with the Sfafe Contractors Lar� 18.27 RCW and <br /> � 296.206-1�AC. ; <br /> i ' i J i� I <br /> ; � �;' _� �_�� - 13 ' <br /> � � ignalure�� Date <br /> I � ' � ---- --- — <br />