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- -- - - --- - . i <br />ELECTRICAL PERMIT APPLICATIOlV '�, <br />CITY OF EV�RETT PERMIT SERVICES ' <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 42:i-257-8857 - www.everettwa.ory <br />, <br />j(- � ,' r N/i- i; I� 1� �� i �� <br />I PROJECT ADDRESS <br />Owner <br />Tenanl <br />�f � . <br />�, t—l�i <br />Mril Address <br />� <br />Mail Address <br />,, <br />,���G��.' _ -i/�c. <br />Electrical Contraclo <br />Mail Address <br />/� �, �,� � � <br />City <br />City <br />� t ��/ �, C> D," I✓ Lv�— <br />� <br />City <br />;��� �' r �= c���'s'� jC"' l' ��� <br />State License Number <br />5 � - �� - <br />Proposed Use of Building <br />�' �� �. � i-���i <br />Square Footage (If resideniial new construclion, remodel or addition) <br />, � <br />�'. i.;'l�` `�C�� 'Iv. "� � .��1 �� ���� 1/. <br />l.. % <br />Number of devices Qf low voltage) <br />�� ' : <br />State/Zip <br />Phane <br />sia�e2iP��/� 5-'� $(� -�l �/ �/ ,�'� <br />l 1 Y�r�' C' /l <br />Slate2ip <br />Phone �i <br />,�� ��L?[/' , <br />ConUact Price of Work � <br />Contact Person (Plan Review) <br />Desr.ription of Work to Be Done: � � � � � �� C � �' ��' ' � � •l � � �� � � ` _ � �� ��� '� <br />� <br />FEE <br />��Z'��0 � <br />CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br />� <br />I hereby ceifify fhat I have read and examined Ihis applicalion and know the same to be tnie and <br />conecL All provisions olla�vs and o�dinances goveming Ihis type ol work will Ge r,ompleted <br />�;liefherspeci/ied herein ornoL The 9rantin9 oI a permit does not p�esurne lo give aulho�ity lo PERMIT# <br />viol�tearcancellhe rovisionso'anyothers!afeorlocalla�vmgula!inyconslnicfionorthe � <br />perlonnance oI consl uc(ion. Thal I am authonzed by the owner o(this property to per/omi the E( j� j_��.f -� <br />.:ork (or which applrcation is made and 1 comply �vifh fhe Sfafe Contractors La�v 1827 RCW and <br />:'96.200 WAC. <br />.L-- C 1 r' � - � <br />� <br />, <br />- ---,�--------' -., <br />