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ELEC�RICAL PERMIT APPLICA710N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32D0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8657—www.everettwa.org <br /> /� a3-�� <br /> C��ro�_ �a3 <br /> 1417 Kossuth F,ve Everett WA, 98203 <br /> PROJECT ADDRESS <br /> James Hickok 1417 Kossuth Ave Everett VVA 98203 425-405-5545 <br /> Owner Mail Address Ciry State2ip Phone <br /> Tenant Mail Address City StatelZip Phone <br /> James Hickok 1417 Kossuth Ave Everett WA 98203 425-405-5545 <br /> EIECtncal Contrador Mail Address City Slale2ip Phone <br /> Slate License Number Conlrad Price of Work <br /> Garage <br /> Proposed Use of Buildinq Contacl Person (Plan Review) <br /> s�� �p <br /> Square Foolage p(r sidenlial new con5truction,remodel or addilion) <br /> � <br /> Number of devices (If low voltage) <br /> oesr.��p�io�or wo�a io ee oone: Upgrading wiring in garage <br /> FEE <br /> CITY OF EVERETT LOCAL SALES 1'AX CODE IS 5105 �r � <br /> I hereby certi(y fhaf I linve read and examined fhis appl�cafion and know the same fo be lrue anJ ✓ <br /> correcl. AU prowsions o/laws and orclinances goveming fhis typc o!work will be r.ornplefed <br /> whether speci(ed herein or nol. 7hr.granfing o!a permif docs nol prosumc fo give au(honty lo PERMR# <br /> vio/ate or cancel fAe provisions ol an�other staie orlocal law re,qulating consfrucfion or the � ��� � ` I � � <br /> peAormarce o/construcfion. 7hat 1 am aufhnnzed by fhe ownei of Ihis pmperfy(o pedoim Ihe <br /> work!or whicb applica(ion is made and I compty wilh fhe Sfate Conlr�cfors La N 18.27 RCW and <br /> 296.200 WAC. <br /> ��,jr.,"•--� ��(./,h<�� ������� <br /> 1! <br /> Signature Oate <br /> aevism.vlrvii <br />