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ELECT�ICAL PERMIT APP�ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE-T, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857 -wwvu.everettwa.org (�,�-�_,�s <br /> �1 �Df�Ifs <br /> / �� �� .�'L S T- <br /> PROJECT ADDRESS <br /> � 21,c Ll ?"o � �y..Jj✓ � - � v � ���--� <br /> Owner FAail Address City � Stale2ip Phone <br /> Tenan� � Mail Addicss City State2ip Phone <br /> own�►' <br /> Eleclrical Contracicr Mail Address � Ciy Slate2�p Phone <br /> State license Number(required) Cily ot Everetl Business License Number(required) <br /> S�f\ <br /> Proposed Use of 6uilGing Contrecl Price of 1Nurk / <br /> �C � � l�ao_ <br /> Square Foolage Qf residential nev�construction, remodel or addllion) Conlact P son/Contacl NumbedL ail <br /> p��, �� - 3�0 _��9 �sqy <br /> Number of device.,(If low voltage) <br /> Descriplion of Work lo Be Donc W �-�-- �— — " ���— <br /> - � ��v���� �i9-G G <br /> �c.___-��(c�,���_.__�,-__—�__ � <br /> �� � � - � <br /> PEE ------ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �O�O <br /> �l <br /> 1 hereby cerfily fl�af I have rcad and e.�amined Ihis aPPlicalron and Nnov�llre same to be frue and —_-- <br /> conecf All provi:ions o/laws and ordinances governing Ihis lype o/t•iodc will be cornplefed — <br /> whclhcr spr.ciGed hcrein ornoL The granhng o(a pennit does nof presume fo give aufhority to pERMIT# <br /> violaf e or cancel 11�e provisions ol any oR�er sfafe or local law, re�uln(ing consf�uclion or!he <br /> performance o/cons(rucfio fhaf 1 am aulho�n r hy Ilie o�vner o!fhis properiy fo perlorm the E I � O I � I I 5 <br /> woik!or v�hich appl�ci rs made an� . �rflly u�ih(hc SG)AConlrard �l.a�v 18.27 RCW and <br /> 29G.200 WAC� <br /> �_�� _ <br /> 2_ �� — ---- <br /> — -ignal��re --- Da� <br /> NEv�SED oProcqo�a ____. <br />