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. <br /> EL�CTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> 3�a-� S <br /> E �so3.-aa 6 <br /> / 3� / f-lr wT A v E <br /> PROJECT ADDRESS <br /> Owner h7ail Address City State2�p Phone <br /> Sknl�en S�i P <br /> Nk�� i<iV � S�e��orJ � 30� i+e�iCfRu� �vwh qg�,o/ 'I2S7fooSYSY <br /> Tenant MailAtldress Qty StatM7ip Pnone <br /> �!as <br /> AGG//JT�V 1��GGT2rC. Co i+v�. 35�5.SH�-T'S� 6V M�-_98� =52-y9y <br /> Electrical CoMre tor M17ail Adtlress C�ty S�ate2�p Pnone <br /> �(C(�itJCc.003t�3� � 3R 35'`a <br /> Slate License Number(required) Ciry of Everetl Business License Number(reqwred) <br /> co <br /> R�i��L col�-�M �� <br /> Proposed Use of Building Contract Price of Work <br /> I <br /> Square Foolage Q(residential new conslruction, remodel or addition) Contact PersonlConlacl Number/Email <br /> Number of devices(If low voltage) <br /> Descripticn of Work to De Done A D fl 9 — OU�'f�_.)C RF�+=��4�� S <br /> FEE <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 �� 5O <br /> I hemby certily fhat f have mad and examined fhis applicafion and know fhe same fo Ge tn�e and <br /> connct. All provisions o/laws and ordinances govemin9 fhis fype ol worh will 6e completed <br /> whefher specdied hemin or not The granfing ol a pennd does not prcsume to grve aidhonty fo PERMIT# <br /> viMafeorcancellhep�ovisionsolanyotherstateorlocallawie9ulatingconstructionorlhe E ��3_ ��� <br /> peAonnance o/consfruction. That!am authonzed by fhe ownerol fhis propeRy fo pedomi fhe <br /> work lor�vhich application is made and 1 compty�vifb fhe Sfa(e Conl�actors Law 18.27 RCW anA <br /> 296200 WAC. <br /> � /r����i��- 3 - 2-/s' <br /> Siqna ure � Dale <br /> REV15E0Ofl06?OfI <br />