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ELECTRI��AL PERMIT APPLICATION <br /> CITY OF= EVERETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8fS10 - FAX425-257-8857—www.everettwa.org <br /> al�� E� Grcr�ctAvP. <br /> PROJECT ADDRESS <br /> I�t�itirk. MPrrae�' �-l9l� V,�ewLl-� �V2E� /,�1,4 98203 �Z5-257-af13 <br /> Owner Mail Addn�ss Ciry SlalelZip Phone <br /> .� <br /> Tenant MailAddmss Ciry Slate(Zip Phon^ <br /> ��mPr <br /> Electncal Contrador Mai1 nadress Ciry State�zip Pnone <br /> � ��oao <br /> State License Number Contrad Price of Work <br /> 5 i nu IP +`-am� lu iZp.Si�tertce <br /> VJ�lli�k M�rriet' �2 q?;3 <br /> Propos Use of Duildin Contad Person (Plan Review) <br /> q40 � <br /> Square Footage Qf re dential new consWctioq remodel or addition) <br /> Number oi devices(I(low voltage) <br /> Descnption of Work to Bc Done: ,�U.� �V��1� � .l 1 ��fll'Y147�0� 1��.1��I1��C� ��l- 17U��• <br /> FEE �,�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �CJLvi <br /> I herEGy cerlily fh�rt I h.�vc rt�ad and exarnineJ Ihis:�pplir.ahon and know Ihe s�m�e lu be Iruc anJ <br /> correcL All pmvisions ollaws anJ ortlirmnces gavemin,q Ihis type o/work will Ge complefed <br /> whefher specrfied herein or noL The granting ol a pemiif docs nof presume(o yive autlionty to PERMIT# <br /> violate or cancel the proNsions ol any ofher sfafe or local law regulating consfn�c(ion or Ihe E � 3 � ,� �4� <br /> pedomiance of consWction. That I am aofhonzed by the owner ol this pmperfy lo peAorm fhe <br /> work lor which application is made and 1 comply with fbe Slate Confradors Law 18.27 RCW and <br /> 296 00 WAC. <br /> h.�,,2�-�--- �����/� <br /> Signatum Date <br /> rewsrnvmu <br />