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- - -� -- -- - -� <br /> � ELECTRICAL PERMIT APPLICATION � <br /> , CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVER[TT: WA 98201 � <br /> ! 425-257-8810 - FAX 425-257-8857 — v✓wv✓ everethva org <br /> I <br /> ; <br /> ' � ��� ������ <br /> � PROJECTADDRESS <br /> ����°�%�l��G7o��' ���G'���'�l���f� G�/ �'�r� <br /> O�:rer idaJ ACtlress City State/lip Pnone , <br /> I <br /> � ienan( 1,1a�1 Atld�ess Ctly Stale/Zip Phone <br /> �(�G/�-'—�f ��. <br /> lectncal Coniracior ldad Atldress Cily State/Zip Phone <br /> ��� <br /> ' Stale License Number Conlra t Pnce of Work � <br /> 5�;��2 �G�� <br /> Pwposed Use o!5uildmg Contact Person (Pian Review) � <br /> ���� <br /> Syuare Footage Qf residential new r.onstruction, remodel or oddilion) <br /> j <br /> Number o(devices Qf lo�v vol�age) ' <br /> � Descriptwn ol Nlork to 13e Dcne� _ ��G'f ��C�C/_�Tl����___.____ <br /> /��i�c'��"'l%��� u/%�-c.f' ��=�� <br /> FEE <br /> : CITY OF EVEHETT LOCAL SALES TAX CODE IS 3105 /Jr� Q U <br /> ( / �i <br /> I hereby certdy thaf I have reaA and exom�ned this 2ppl�cation and kno�v the same (o be t�ue and � <br /> � correct. All piov�sians olla�vs and c�dinancrs goven�ing lhis type ol�vork will be compleled � � -- <br /> ivhclhcr specd�ed hr.iein or nol Thc gianGnq ol a pemirt does nol presume lo give authon!}�to PERMI T.t I <br /> ciola(e or cancel Ilre provisions o!any other sfale or local larv regulafing cons(ruchon or the '. <br /> pe�fomiance ol cons(n�ction. Thaf 1 am au(honzed by the o�vnero/fhis prope�ty(o perlonn the E � �� U - QS j ' <br /> r.ork lor which appLcotion is made and I comply k-dh the State Confracfors Law 18 27 RCIN and <br /> ?96 200 �— <br /> �� Sianature ����te � <br /> � _�ns�: �._ � I <br />