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' - - <br /> ELECTRICAL 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 /> 07 �/ � %�C'l�tlr � <br /> PROJECT ADDRESS <br /> T� � t� � <br /> Onn i1 ,� 1�.��,�z.. Nl� � ���,-- 3�d�j /G� �E, S�,ol c,����s� ��. 9��I;7 <br /> Owner MailAdCress Ciry Stale/Zip Phone <br /> ��,�,rs�3y _�i �:� <br /> Tenant Mail Address Ciry State2ip Phone <br /> �W � e� <br /> Electrical Contractor A1ail Address Ciry State2ip Phone <br /> .��-� �0, <br /> State License Number Contract Price of Work <br /> c' or�rn . <br /> Proposed Use of Building Contact Person (Plan Revie�v) <br /> Square Footage Qf residential new construction, remodel or addition) <br /> Number of devices Qf low voltage) <br /> Description of Work to Be Done: /�E�l U Ca C�2�ir/�'�a�P <br /> I <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 C� � 5 u <br /> 1 herehy certily that I have read and examined t6is application and know Ihe same tc be frue and `� <br /> cormc(. All provisions a/laws and ordinances goveming this type o/work�vill be completed <br /> jI �vhefher speci/icd herein or not The g�anfing o!a pennif does not presume to give aidhonty to pERMIT� <br /> violate orcancel the prov'sicns o(any ofhersta(e orlocal/a�v regulating consfruction orlhe E � 3 � � .��� �� <br /> pedormance ol con.�uuction. Thaf 1 am aidl�orized by the o�vnero/this propeRy to pedonn the ��J <br /> �vo�k �or whicA application is made and 1 comply�vith(he Stafe Conhactors Law 18.27 RC W and <br /> 296.z00 WAC. <br /> I }, � ? <br /> /%C��' ���i�t- , ✓ .�/� J <br /> --�'ignature Date <br /> newsea_ina» . <br />