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ELECTReCAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, VJA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —�vnn�v.everetriva.org � w � �09 � � <br /> �1-3—i cr <br /> 2/� �'�'.,'�,e11/� ��.� ,��'��,,��, �d�i cT <br /> PROJECT ADDRESS S� i <br /> ✓r�P-��JN I`�G ,�35/� <br /> � i� � �O wi�����,����r/»s 8/3-�Y6`�_3��� <br /> I Owncr f.1ai�Address C4y Slale2ip Phone <br /> �--- - i <br /> I �' � <br /> i <br /> Tenant Mail Aatlress C�y Slate2p �'��Q��"- <br /> VVU ��1 <br /> EleUrical Contractor 1.1ai1 Address CAy SIa:e2lp Phone i <br /> I <br /> Stale License Number(requireA) C!ty ol Everelt Eusiness License Number(rcquired) II <br /> I I <br /> I <br /> I Proposed Use o(Buildmg Conlract Price ol Work <br /> I <br /> i <br /> Square Foolage (It residenhai new construclion, remodel or addition) Contact PersonlContact NumbedEmail i <br /> I <br /> I <br /> � <br /> \umber of devi:es QI low voltage) � <br /> �� I <br /> ` ' I <br /> Description ot�Vork to Oe Donr �`���I�`"N c av-d�C E���N�J�--����-V�—/ I <br /> �/�s/1���l��-���(�'t[�t`�-?'�--. .._ — -------- ' '� <br /> I — --- ---- FEE II <br /> I CiTY OF EVERETT LOCAL SALES TAX CODE IS 3105 �O� �'i <br /> 1 hen�by certi(y tha(I have read and eramrned flris applicafion and kno�v fhe same (o be We and ._J <br /> corrocl. �If provisrons olla�vs arld ordinances govemmg this type ol wo�k�vill be coaipleted ----- <br /> �vhefherspec�fied7re�ein ornot. 7he gr�nfing ol a pem�d does nol presume fo give a�dhonty fo pERPiIT�t <br /> viola(e or cancel�he prvviswns ol any ofher s(ate orlocal I�w n�gulating consfniction orfhe /� I � <br /> perfomrance olconsfn�cfion. rhat I am aufhonz d by the o�v� er o/fhis piopedy lo pedomi Ihe E w� �-aq - (,/O <br /> �vork Ioi�v'iich appli �h n is made And 1 om �v h the State Contrac(ors Law 1827 RCW anJ - � <br /> .'796 200 i� . -� <br /> � /l� / <br /> , , � _ � ���'_ �` - �'� � <br /> iycawro ua�e <br /> r,�vr.t::nsc,�.:o,i / - ----- I <br />