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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810 • FAX425-257-t3857-www.everettwa.org —10 —l�{ <br /> � l�f�oy -o�;v <br /> �c1�� �e- ��--- asc� -�7� <br /> PROJECT AODRESS ���'� <br /> o�r� �a�� �-���\ ��c�c. P,ne �., �vQC���. G �b I <br /> Q�ef Matl AEdress Cny Stale2�p Phone <br /> Tenanl <br /> htail AtlCress Ciry State2ip P�one <br /> ���� ����-�� .: � ��,��,�����.c � �-�c`�1�C� <br /> Electncal Contractor L1a1 AdCress Gry State2�p �I � . .. k�ai�� <br /> �u-,'ttl-l� <br /> ��T��cn n�t � ��� � <br /> State License Number CoMrad Pnce of Work <br /> ��c�1� 1 <br /> Proposed Use o(Building Contact Pcrson (Plan Rev�ew) <br /> SQuare Footage(II residenhal new construction,remode�or additlon) <br /> _� <br /> N er ol aevlces(II low voltage) <br /> Descnption of Work to�e Done: ���,�� �\�—�� ��� ` �C��--`�=��C � <br /> „;�.��� c\ \ �.�e\e� a. � <br /> ��i�',��,��c�\C c� �� �1�CE'S <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 �OO <br /> !hereby certily fhaf 1 have mad nnd examined fhis applicafion and know Ihe same fo be f/ue aud <br /> cormcL All provisions of laws and ortiinances 9oveming fhis type o/work w�ll be compleled <br /> whether speci(ed herein ornoL The granhng o!a pernrd docs not presumc fo give autho�ty fo PERMITx <br /> violate or cancel fhe provisions o!any ofher stafr, or local law mgulating constnicfion or fhe � I�O� _O—r� <br /> perlortnance o/construchon. 7Aaf I am authonzed by fhe owner of Ihis property fo pedomi fhe � <br /> work lor which appOcahon is made and I comply wifh fhe State Conlracfors Law 78.27 RCW and <br /> 296200 WAC. <br /> ��� � ,� y—�D �I <br /> igna ure � Date <br /> ��visEo i�vi� _ <br />