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ELECTRICAL PERMIT APPLICATIOiV <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I425-257-8810 - FAX 425-257-8657-www.everettwa.org <br /> 1�1�- ��cza��n ��� <br /> PROJECT ADDRESS <br /> I'�Un�� �TrC�r� �31� L-�R�s-�-� �v�r�-�-r `,�.� RY 2� <br /> Owner Mail Address Ciry StatelZip ��� 530 �honr�e <br /> �v, <br /> Nl� <br /> Tenan Mail Address City Stale/T.ip Phone <br /> ��11�1=� <br /> E'edrical Contraclor Matl Address City StatelZip Phone <br /> State License Number Coniract Price ot Work <br /> h�,�.lkta(-� <br /> Proposed Use oi Building Conlact Person (P�an Revfew) <br /> "�f'r0 <br /> Square Foolage(If residential new construction, ramodel or adAition) <br /> bl.� " L� 1A(a��OI� D�r�1Z <br /> Number of devices (Il low vollage) <br /> � / <br /> Descriplian of Work lo Be Dane: _��n GL�7l��T 5 � � � 14-{' �� �f7 C.1���� <br /> FEE � �l\,� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � V V <br /> 1 hereby certily fhaf I liave read and examined Ihis applicafion and know the same�o be tnre and <br /> correct. All provisions ollaws and ortlin�nces goveming fhis type ol work will be complefed <br /> whetherspecified hemin ornot. The granting oI a permit does not presume to give aufhority fo PERMIT# <br /> violafe or ct+ncel the provisions ol any ofher sfate or local law regulafing construction or fhe � { �I^ ✓ I�Q <br /> peAom+ance ol consfruclion. That 1 am aufhonzed by the o�vner o/this prepeRy to peAorm fhe � L (� <br /> woilc/or which applrcation is made and 1 comply wifh the S�ate Contracfors Lavi 18.27 RCW and <br /> 296.20 � <br /> �' �� � I �� \��� <br /> ignature Da�e <br /> RFV�SFU 1?N77 <br />