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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C[DAR STR�ET, EVERETT, �VA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -vnvw.everettvra.org (( —1(� --�l� <br /> C—�464 —II Z <br /> �l8 �� k �� � E,�� �� 9��3 <br /> PROJECTADDRESS <br /> Owner MailAddress Gry Slale/Zip Phanc <br /> Tenanl PAadAddress Gty State/Lp Pnone � <br /> ��� «���}3��7� <br /> � � LL � ��/�i�.l�r,��t� � rr�/i/ (,v ��� <br /> .��=^c� ��� �/<<�,-.� � — <br /> EledricalConhactor P.taJAddress Cny — , Sta, �'z�p Pnene <br /> r,.+ <br /> �v4 d �s� 9�� t�c1 /G 0 U <br /> Slale License Number Contrad Frice ol'+^.�o�M. I <br /> � � � � � <br /> Proposed Use o(6uilding Conlact Person (Plan Review) <br /> Square Footage(I(residential new construclion, remodel or addilion) <br /> .- I <br /> Num6er ol devices (II low voltage) <br /> Uescriplian of Wark lo Be Done: ('-���'�� �QtZ- �Q 0��� C�f�• � _— <br /> �� �.4���G��--�--�a^�� �'o✓���� — A(Xk<� _� �� <br /> _L�IL�,Y� °�--1 4 hLt�i,�l—_ e � - �r/ Q!—��f J: <br /> � � <br /> FEE � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 � � O� <br /> I hcreby ceRily that I have read and examined this applicafion and know the samc to be frue and <br /> conecL �111 provisions o/la�vs and oNrnances goveming this type o/�vork ivdl be complMed — <br /> vihefherspecified herein ornoL The granfing ol a permit does nof presume fo give aufhonty(o pERMff� <br /> viola(e or cancel lhe provisions o/ ny ofher sfafe orlocallaw�egulating consfn�cfion or fhe r ' , (�1 �— <br /> per/onnance of consfn�c(iort Tha 1 am au(honzed by fhe owner o/fhis propeAy fo perlarmlhe C "I V � ( '� <br /> �vo �vhich a plic� 'ai is ia �and I comply with fhc Sfate Conlractors Law 18.27 RCW and <br /> Z 6200 AC <br /> . �i��� <br /> Si a wc Datc <br />