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1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.evereriwa.gov q`O� —( 5 <br /> I <br /> ��Jo�-Lt�S <br /> oZl �� Pl�1t= S I�. <br /> PROJECT ADDRESS <br /> OWnBf MailAddmss City Stale/Zip Phone <br /> w►«<� �nnA�JU�n� a�loy P►�;� s? c`�ue�,r�- w� qg��� YaS-3��l-sba�. <br /> Tenant Mail nddress Ciry Slale/Lp Phone <br /> R, 3, c4_G�� aov� ,�,.� �v ��� s�. s�b���,�� wa 9���� ao�-9�c q�x.s� <br /> EleGtfiCal Contrador Mail Address Ciy SlalelLp Phone <br /> Ra����lc� �3� K7 OS3S �o1 <br /> State License Number(required) City of Evered Business License Number(required) <br /> ��5�� ru���;e-� �. vo <br /> Proposed Use of Bwlding CoNrad Prix o(Work <br /> �� e�z`��'- Q�t4S�59 <br /> Square Footage(If residential new wnstrudion, remodel or addition) Contad PersonlCon d NumberlEmail <br /> r�ck, sY �(,�f-++�i�l . co�+n <br /> Number of devices (IF low voltage) <br /> Description of Work to Be Done�. 1�(%-��'f 1�. �N l_"f,� AN� �l, ��-- �'E'���l� <br /> S 1`IPa ILI= �� IiX �$ l � �Lr z�Ul� �@v�.� .S�' U l C.� r/�� l�L <br /> C�AiCx�,aL. C��t-� T�4lC�� �ac»N t� i�/dc�,z�� i7�'-c�t'� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��� �i <br /> 1 hereby cer&ly Ihaf 1 have read and exarnined fhis apphcation��nd know fhe same(n be true and <br /> co�ed. All provisions o/laws and ordmances goveminy fhic type ol work will be complefed <br /> whether spccificd herein or nol The g�anling ol a permit does nol presumc fo g�ve aufhonty to PERMIT# <br /> v�olatn,or cancellhe p�ovisions of any other sfnte or local law requlafing consfruclion or fbe E 15 0 �h <br /> peAormance o/consWIXion. That 1 am aofhonzr.A hy fhe owncr o/fhis property lo peAorm fhc � �' Io5 <br /> work In�which applicafion is mt�Ae and I comply wifh thc S(afc Confractors Law 18 27 RCW and � <br /> 296 200 WAC. <br /> ��. ��. �L 9- / - �s <br /> Signalum � Dale <br /> newst.oawnv,ni� <br />