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— � —� -- <br />ELECTRICAL PERMI� APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8210 - FAX 425-257-8857 - www everettwa.org <br />2 7 Z � L q�rc �.� _�./t , <br />PROJECT ADDRESS <br />rr - a��-�3 <br />C /3 �i -i.S3 <br />r"� rc�uo r'1 �l�e,�z�� z�z� LA�rc..� J�. �•�e� r� u,� ��3 yzr 3srd ��� <br />Ownef MailAdtlress Gly SlatelZip Phone <br />7enant <br />Mail Atldres5 <br />Gty <br />Stafe/Zip <br />Phone <br />' i3 ; (�,fn�t�Y G�Eci PD i✓,�' 7vv �y,✓�vw000 t✓��. 9fso � ���9 <br />—� .- <br />li [IectricalContractor �v1adAddress Gly SlatelZip Phone <br />13Erl�r}-Oi 93z-c� <br />State License Number <br />%Z� 5 _ <br />Propos�_d Use of Build�ng <br />Square Footage (I( residential new construction, remodel or addrtion) <br />�umber ol devices (Il low voltage) <br />�/ <br />Oo <br />Contract Price of Work <br />Comact Person (Plan Reviev✓) <br />Uescriplion of Work lo Be Done� ___ �o �J ✓E it r' 2yp V /�� _�'l�TS � _. <br />_�__2o v i� rr ci.zc��� - <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereGy certdy (hat I have read and exammed (his application and know fhe same fo Ge liue and <br />correcl A�I provisions o/ la�:�s and ordinances goveminy fhis type ol work ivill be completed <br />whether specilicd heiein or noL The granting oI a pemiif does nof presume fo give authonty to <br />v�olate or cancel the provisions ol any ofhe� state or local law �egula(ing conslrucfion or (he <br />pe�formance ol consWction. Thaf I am authonzed by fhe owner ol this property (o peAonn fhe <br />svork lorn�hich ��pphcafmn is made and I comp/;� wdh (he Stafe Contractors Law 78.27 RCW and <br />296.20D WAC. <br />/� (: i��C,�— -- I r- z �— I 3 <br />REViSED ]RO/1] <br />f-EE I <br />���`� _� �I <br />PERMIT� <br />E13�1- 153 <br />