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ELECTRICAL PERMIT' APPLICA�'IdIV <br />CITY OF EVERETT PERMIT SERVICES <br />320o r�DAR STREET, [VER�TT, ��VA 98201 <br />d25-257-6810 - FAX 425-257-8857 - t+nvw.evereitv:a.org <br />�, P,HeN�er��,9v� <br />PROJECTADDRESS <br />�enanl <br />Eledricat <br />r.1aJAdCress <br />Mail Address <br />Pda�tAAdiess <br />��-Y���o(�� <br />Slale L¢ense Mumber <br />uC'S* �___I <br />G;y <br />C�ty <br />—!— % W <br />Cdy <br />,;.Q �,. <br />�roposed se o( Bwiding <br />Square FoOo e(I residential new conslructioq remodel or addition) <br />Number of devices (If low vollage) <br />Slalc2ip <br />StaielLp <br />Slate�Z�P <br />� _,��'-ay <br />� 1�b7-/°7/ <br />�300 ,_DO <br />Conlrad Pnce ol':Veik <br />Phone <br />Phanz <br />/�f�,��� <br />Canlacl Peison (Plan Reviev <br />CITY OF EVERETT LOCAL SAL[S TAX CODE IS 1105 <br />1 hereby certdy fhaf I Aave iead and e.eamrned Ihis appficalion and knmv the same (o Ge fiue and <br />r.onecf All pmvisions olla�vs and ordinances goveming Ihis type ol werk �vill be complefed <br />r�hethcrspec�ficd hcrcin ornoL The gianting o/a pe�mit does not presume (o giie aulhonfy fo <br />violale orcancd (he provisions oI any olhersfa(e or/ocalla�:• regulafing consfruclion o,-!he <br />peilomianceo(consfrucfion. Thaf/amaulhonzedbyfheornerollhispiope�fy(opeAormlhe <br />�vork /orwhich app�icafion is made and 1 comply with fhe Sfate Conbactors La�v I B.27 RCW and <br />246 200 W!1 C. <br />FEE <br />�O� <br />PERPICI'» <br />�I�-Io�-��� <br />