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___ __- �-- _ __ - _ --- ,-- - - - _ _ <br /> � <br /> � ELECTRICAL PERMIT APPLICATION , <br /> � CITY OF EVERETT PERMIT SEI�VICES <br /> 3200 CEDAR STREET, EVERETT, VJA 98201 <br /> , 425-257-8810 - FAX 425-257-885'� - v,nvw everethva org <br /> � <br /> ' ��-�,�� <br /> ' PROJECT ADDRESS <br /> � <br /> �/� ,�--� //�,�70�� y�L���`�I���f�G G�/ ��� ; <br /> O:+r,e� L9a�lAdtlres5 Gty State/LO Phcne <br /> Ten2nt NlailAOtliesS Cdy SlatelZip Pnone <br /> I ' ///� <br /> ���11 L"<� <br /> . �"�IecincalCon��actof t.ladAdtl:ess City StatelZip Phone <br /> ,� '� � � <br /> Stale License Number Contra t Pnce of Work �� <br /> S�i/2 L>�, � /-- <br /> , Proposed Use o(Building Contacl Person (Plan Revie�v) � <br /> � !y_L!v <br /> i Square Footage Qf residenlial new construction, remodel or addilwn) ' <br /> �� j � <br /> Number of devices(f(lo�v voltage) <br /> i /'� <br /> ' Descr�ption of Work to Be Done� --��—(�"' �.� �v /' �C�-f/ ���� . �-----.__ . , <br /> � /S.r[_:r/tL�-���—��_!/��_�"<f /��2.1��.�� �, <br /> <i <br /> , -- — � <br /> ' FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /J(� a� I <br /> � ��� <br /> � 1 hereby cerTil}�fhat I have read and exam�ned this applicatron and knoi•e fne same to he In�e and ____ ' <br /> rorrecL All p�ovisians o/laws��nd ordinances yoveming this type o/�vork�vill be completed � <br /> ' r.I�efherspeaGed herem ornoL The gr��nhng o/a pennd does not p�esurne(o groe authonty to rpERMIT'i �� <br /> � viola(e or cancel the p�ovisrons o!any ofher sta(e or local law regulahng constn�cfirn or(he ^ <br /> peAomiance ol construction. Thaf I am aufhonzed by fhe ownerol this property(o perlonr(he t ( 3�(� . D s� <br /> � v:ork lor which applicalion is ,r.ade and I comply wi(h Ihe State Confnctors La�v 78 27 RCW and <br /> � 296.200 - I <br /> � � ��� � <br /> � S�gnzWre ate <br /> FEYISE�3'�OnJ _ _' �. I <br />