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SEP-11-2084 91:27R FROM:PROFESSIONRL ELECTRI 3fi0 435 1182 T0:4252578857 P.1�1 <br /> • • <br /> ELECTRICAL PERMIT APPLICATIOIV <br /> CITY OF EVEI2ETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257 8857 —www everetiwa.org <br /> �/ 8 ����..� /��c <br /> PROJECTA�DRESS <br /> C , i oiSo iyi� ��o � � � � ,�,l�r wA S ��o � <br /> Owner MellAddress Cily � SlalelZip P�une <br /> Tenanl MailAddress Clty Slale2ip Phone <br /> '/�I=J'�:.. -,;1 J� G <br /> �� 'Ie' S' 3 i / ��ec � � fr. c / V Li ��/�'J �r�.-•..� �i-. Gl�a �7 ��1 Z <br /> i i"v <br /> Elec�neaiConlracior MBilAE0re55 Clly � SIn1e�Zip Phone <br /> [� /:[. f�!% /= 10 7 ,t A � . . <br /> S1ate License Number(required) Cily of Everell usiness License Number (required� <br /> Re .r,�l.,« �� <br /> Proposed Use al Building Conlracl Prite of Woik <br /> Square Foolage(If residenlial new conslruclion, remodel or eddilion) Conlact Person/Contact Number/Email <br /> Number of devices(II low vollage) <br /> Descriplion of Work to Be Done: �r/� ,� /lt�.�J'1 �'��� /'e �D co7�t <br /> 3 l' .-ec�� / � a�� �/ ��c;�h� / .s <br /> FEE b <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 5105 (�7o D� <br /> I hereby certily thef I have read and eremined Ihis applicefion end know!he snmA In he fn�e and / <br /> coriec(. All provisions o/Inws and ortlinances goveming fhis fype o/work wilf be completed <br /> wnelner speci�etl Aerein or nof. The grenling o!o permlf does nol presuma fo give aufhonly to PERMITi! <br /> viofeto o�cencel the provisions o/eny ofherslafe orlocellew.ygulefing conshuclion orfAa �� ���_ ���� <br /> pe�lorrnence ol consfruction. Thet I em nufhorized by Ihe ownero/fhis property(o peAonn Ihe <br /> work!or wnicn epplicatlon�s mede anU 1 comply wlfh f�e S(ate Contracfors Law I8.27 RCW and <br /> 296200 WAC. <br /> ��.,,� N>;�.�. �-�a -�y <br /> SignaWre " Oale <br /> ar.-v�seoaaocnoia � <br />