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- -- - — -- <br /> ------- -- - --i <br /> _ _ ---- - - � <br /> : ELECTRICAL PERMIT APPLICATI�ON <br /> I CITY OF tVERETT PERMIT SERVICES <br /> I 3200 CEDAR STREET, EVERETT, V+lA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —wv✓w.everettwa.org <br />; <br /> � <br />. � <br /> � ,� <br /> I � 3� � L `1 ���, e v��.�. � �c <br /> � PROJECT ADDRESS <br /> I <br /> � <br /> IOwnef MailAddress City Stat=lZip Phone <br /> I <br /> TenaN Mail Address City StatelZip Phone <br /> i � <br /> 7— � '1����c�v �zc�C rUl�FS '�LC ��' ZP��S 7 6i��Y���r' �(IS �I?�3Z� �_ <br /> II Eledri � I Cont�ac�or Mail Address City StatelZ�p Phone <br /> i �-�(��� / �zv� <br /> I �� ""' ` Contract Price of Work <br /> Stale License Number <br /> I I�L' S1c��t'f/�`{t2� C <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �I' Square Footage Qf residenlial�evo construc�ion, remodel or addilion) <br /> � Number ot devices Qf lovr voltage) <br /> Description of WorK to Be Done: � n/C �Y' 1C�-�'F'� �Y�-V1/1-�� ���`�� �� V ��� �l' 'e � <br /> i <br /> � <br /> FEE I� <br /> 1� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � � _� (� U <br /> I�� 1 hereby ceRily that I liave read and examined this applicafion and knor�the sarne to be true and <br /> correcl. All provisions o(la�vs and ordinances goveming lhis type ol woric�vi116e completed I <br /> �ahetherspecilied hereirr ornoL Tne gran(ing o(a pemiif does not preswne lo give aufhonty lo pERMIT# � <br /> � � �iolate or cancel the provisiais ulany othersfate orlocallmv irgulafing consfniction or the ,� <br /> perloimance o(cons(n�ction. Thal 1 am atdhorized by fhe otvnero/this property fo perfo�tn the E ` `�'��j — �12 7 II <br /> �vorF inr which applicalicn is made mid I comply with!he Stute Conlractors Law 7827 RCW and V <br /> 296.200 WAC. /�-/� <br /> ?;_%������ �/��i � <br /> - Siyae re ° Date <br />