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ELECTRIC,�►L PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C�DAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> �, � � �-��� ^-^� � <br /> . <br /> PROJECTADDRESS <br /> \ \ � ` , . .' �._ i " 1 :"�`--1 \`,��_'.-i� , �; . , ' <br /> Owner, MailAddress City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> , <br /> . ` .; , '� ;--, �> � I � <br /> , , �. , . \ , ' . , <br /> EleclricalContraclor � MailAddress City SlalelZip Phone <br /> � <br /> , •. ' . . : .� � �, l _ .� . � ���� �. <br /> Sta�e License Number Contract Price of Work <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> � � :/- <br /> Square Footage (I(residenlial new conslruclion, remodel or addition) <br /> Numter of devices(If low vollage) <br /> Description of Work to Be Done: =;'�='` � � �� ' ��� � �` ���� . �� �' <br /> �� .� �� _ � ',���, ����L. <br /> I <br /> � <br /> FEE <br /> CITY OF EVERCTT LOCAL SALES TAX CODE IS 3105 ��. (�� <br /> 1 hereUy certily fhat I have read and examined this application and know the same fo be tnie and <br /> correcL All provisions of laws and ordlnances goveming fhis lype o(work�vill be completed <br /> whether speci�ed herain ornoL The grantin9 o�a pemiit does not piesume !o give authonly to PERMIT# <br /> �I :�iolafe orcancel the provisions ol any ofherstafe orlocal la�v rege!ating a as6uction or(he ` <br /> � performance o1 construcfion. That 1 arn authonzed by fhe owner ol this prope�fy fo pedonn fhe E � ��`, ��� <br /> work lor�vhich application is made and 1 comply wifh the Slate Ca�tractors La�v 18.27 RCW and <br /> 296.200 WAC. � <br /> I . -, <br /> _ /�X i � Dale `\ �- ` I , <br /> ' SignalLre � , <br /> V <br /> i�LN5:�03'10/II <br />