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r <br />I <br />ELECTRICAL PERMIT AP'�LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />i <br />� � ��� <br />PROJECT ADDRESS <br />Ovmer <br />Tenant <br />: S �''ro� <br />Mad Address <br />Idail Atldress <br />s Elr�°, 7,3,� <br />ElectncalConiractor �d�lAtltlress <br />Gry <br />Slate/Zip <br />Phone <br />Gty State2ip Ph e <br />��'�s�. �fir� �S���U��� <br />�? �� � � �.�-z'� s �� q <br />State L/icense Numher <br />L'J�'t �!'� <br />Proposed Use of Bi ding <br />�tov <br />Square Fool2ge Qf resdenti nev� conslruction, remodel or addihon) <br />/ <br />Number ol devices (I( Icw vollage) <br />Descriplion of Work to Be Done <br />Gty S;ate/Zip �D��� Phone-7�O <br />C�'/ ;�Q�/ <br />�/ ��- �. <br />Conirac� Price of Work <br />Contac� Person (Plan Revierr) <br />CITY OF EVEP.EIT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily thaf I have read and ex imined this applicaGo� mid kaoiv fhe sanic (o be hue and <br />correct. �ll provisions ollaws and ordinances goveming (his typr ol �voric wdl be comple(ed <br />�vhelher s � ed herein or not The granting ol a pennit does not presume �o give aufhonty fo <br />violafe cance theprovisionsolanyo(herstat o calla�vregu;atingconsWcGonor(he <br />peAo ance ol c nsfruction. That 1 ant ulho '• the owner oIl!�is pruperty fo pedorm the <br />r+ork r which ap licalion j$ mar �i�o p w(he Stale Con(rar.lors La�v 78.27 RCW and <br />296 00 WAC. // � <br />A��,s��,�o:,, <br />FEE <br />�S o0 <br />PERMTT?J <br />�j3c��— lg <br />� ��v�" i, .,,*�. ','.'+�:��. �,� :r+� � ��� a <br />_ � �u <br />�._.,_.. lL��'� 4 �_ . ���� .i>_� . <br />