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j- - --- ------� -- - ---� --- — <br /> 1 <br /> ELECTRICAL PERMIT APPLICATION , <br /> CITY CF EV�RETT PERMIT SERVICES ' <br /> ' 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I 425-257-8810 - FAX 425-257-8857 —www.everettwa.org , <br /> � I <br /> i <br /> 2� ,� . ��,��y ��� . � <br /> PROJECT ADDRESS <br /> '� ��g� i���+-+ Z� E ��.r,��rTy ��� E�� w,� . 96�8 �'zs�2z-33�-s <br /> i Owner �AaA Address Cny State!Zip Phone <br /> Tenant t�:�a�i nAdress C,ty StateiZ�o a��one I, <br /> � yL5� <br /> �qNl�QnIC� �EJ..(oy S/r�,a/%G�.S /o22g /'.�al,�.l ,ST ��cCC.�c,dR ��oN ygl-Q(�� <br /> � <br /> �Iecincal Contrac�or t.taii nCCress Gty State'Zia °nore I <br /> S�Nn/braESolo2-�S ySo� �� I� <br /> Siate License Number Contract Pnce of Work I <br /> � F2- I <br /> ProposeA Use of Bullding Contact Person (Plan Review) I <br /> Square Footage(If residential new consiruclion, remodel or adddion) �I' <br /> I <br /> � <br /> I / <br /> Number of dewces(If low voltage) <br /> I Description of Work to 8e Done. /OQQ/�✓�' C'��`'L'U�� r�7� A N�(r-� d U��S� NEl1"��Gl/'AP <br /> I <br /> � — <br /> � <br /> IFEE <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 /� I1 � <br /> "JV <br /> I hemby ceitdy that I have read and examined(his applica6on and know the same to be(n�e and __ <br /> correcf. All pmvisions ollaws and ort/mances goveming(his type ol work will Ge completed - --- -- <br /> whether specfied herem or not. The gran6ny ol a pemuf does not pmsumc lo givc authonty fo PERMIT# <br /> vinla(e or cancel fhe provisions ol any ofher sfate or local law regulafing construc(ion orlhe <br /> perlonnance o/constn�ction. Thaf 1 am au(honzed by the ownei o/Ihis propc�ty fo pedorm Ihe E � yo �_ p 33 <br /> work loi whi a lication is made and I comply�wfh fhe Stafe Contractors Law 18.27 FC W and <br /> 296.2001�y , <br /> / <br /> !�b-� ! <br /> Sign Date <br /> �. , ..,._-_i�u <br />