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- - - �-- - - --�- ----- - <br /> ELECTRICAL PERMIT APPL!CATI�N � <br /> CITY OF EVERETT PERMIT SERVICFS <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 <br /> a25-257-8810 - FAX 425-257-8857 —www evereriwa.org <br /> ; j <br /> � � <br /> � �3 /l f�R�ihC� /�vE fvERE %T, 982a <br /> PROJECTADDRESS <br /> IMD,u(CA f-'EL_SaN ----- ---- Z� $/9- 73i/ <br /> � O�.vn2r Gta.l A74ress Cdy Sialc/1�p Phone I <br /> /sR�¢N A1�C�S 33// /����� Av6 ��CnE77 �-'/�. 98zo� �os-.7�o. 9�YZ5 <br /> � Trn�n[ h1aJ A�dre;z C�ry Stalellip Phone <br /> � <br /> I /ho�.uicJ9/�f E�G7'tiC GtL. syo'L 2Z/J�Si. sw. Ma,.�:taic6 i��4VJ�� <,.�7. 9Ba'!7 YLS-.f�3-88JC <br /> ElectriCal Contraclor M11ad AOdress Ciry Slate�2�p Pnone <br /> /1�a�N?C��,66 M S �� ' � �' SS � <br /> � 5!ate l.�cense IJumoer freqwred) City of Evare Business l�cense Number(reqwred) � <br /> i <br /> 9� � I <br /> �. Proposed Use ol 6mltlmq Coniract Pnce of Work ' <br /> I� pAu� /SMrm9ti�Yj.s�.s63' BB7� . <br /> Sauare Footage p(residential new consiruUioq remodel or atltldion) Contact PersonfContact umber/Email <br /> N m r of dewces If low vclta e <br /> j u be ( 9 1 � <br /> i <br /> % � <br /> DescripUon of Work to Be Donn S�Q �PANCL C(1qNGre ____ i <br /> li I <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 ;� � ��j '� <br /> II hereby cert�ly fhaf I have reaA and examined fh�s applicahon and know fhe same fo be hue and __ <br /> cn�mcf All prov�sions o7lav�s and ord�nanr,es 9o✓emrng th�s type ol work wdl be cornploted - <br /> �vhefher specdied herwn or nof The granhng ol a permif does nof presume to g�ve aufhonty(o PF.RMIT7J <br /> � vrorate or cancel fhe yrowsions ol�ny othe�stale orlocal�aw regulatrng conshucfion or tho r I� r � J O I „ <br /> pr,Aomiance ol consfruchon Tha(I am aufhonzed by the owner o(thrs propeAy to peAorm fhe t � /� I <br /> �. �,rora for wh�ch applicahon rs made and I comply wRh fhe Stafe Contrscfors Law 78 27 RCW and _� <br /> ?95 200 WAC. <br /> � � /L��Y <br /> � Signalum DaTe— <br /> -:,-:t�r$EOOet6?0 iJ <br />