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- - - � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEFiETT, WA 98201 <br /> 47_5-257•8810 - FAX425-257-8857 —www.evereltwa.org ��/—/� <br /> Cr�r���o� <br /> �Z�s P�n� S'�f <br /> PROJECT ADDRESS <br /> Owner Ma�lAddress CAy Slate/Zip Phone <br /> Tenant MailAddress City State2�p Pnone <br /> T—� <br /> L%�r �(P��� 3z�Z i�r-�. S�r S� �r�(-� � �g�� s3�'� <br /> Eledrical Contraclor Ma�i Address Cdy Slate2ip Phone <br /> I ���/-��l_ �� �j ��E� .�11 �j��r'l SS �_ I <br /> Slate License Number(requi;ed) City of Everetl Busmess Licens� Number (required) <br /> Zb � � eO -- <br /> Proposed Use of Building Co�oc�ricG�'rk �Z� �,7� s�,� <br /> � 1c�0 � S�� — tineo�re(ec1�-lc c� o �-� <br /> Square Foola9e pf residential nev�construction, remodel or adddion) Contact Person/Contact NumbedEmad � ^ � <br /> Number af devices (If low voltage) <br /> Description of Work to Be Done�. ��� ��r� 2-� �u �F _�I—� <br /> FEE <br /> CITY OF eVERETT LOCAL SALES TAX CODE IS 7105 C�D� <br /> I <br /> I hereby ce�tily fhaf I bave read and examined this applicafion and know the same to be lnre and <br /> -orrec(. All provisions o/la�vs and ordinances goveminy fhis fype ol work�vill be compleled <br /> �vhelher specified hcrein or not The granhng ol:permit ooes nof presume(o give authonty(o PERh1[l�� <br /> violate ar cancel fhe provisions ol any other s�af� �r local la�v�egulafing construclion or the <br /> perlonnance ol cons(rtiction. That 1 am authonzed by fhe o�.vnerol fhis prop^rty to perform the E �tI��{t'jq-�b <br /> �vork for�vhich a �lication is made and 1 comply�vith the Sla;e Conlractors La�v 18.27 RCW and <br /> 296200 Ih�AC. <br /> �--ry- zA � '� <br /> I i i,, Date <br /> rEt95EooH,D6?ata �� _ _� <br />