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� ELECTRICAL PERMIT APPLfCATION i <br /> I CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425257-8810 - FAX 425-257-8857—www.everettwa.org <br /> 12 —�--13 I <br /> ����2 -��2 <br /> � 3 � `� o� KLS <br /> I PROJECT ADDRESS ' <br /> � ���1�A�2-Q �'��Yt-�=�N �io1-`�-I°('S �Sw I.�NNwc��fl;WC� �iZS-'�`� 6-?.b'fo` <br /> I pwner MailA00ress CRv StatefZio PAone i <br /> i ' <br /> i ' <br /> iTenant MailAdaress Cky StateJZip Pnone I <br /> �q� p C' � 1 �� '77(�,'2E31� � <br /> I J��U �C1� \C1U12��-� I�b - �¢� `1 �L �� h���Ck`L-� �� � D�� _ <br /> 1 Eletlrical Coniractor Mail AdCress Crcy StalrlZio PAo� i <br /> I , <br /> I Stete License Number Contrad Price of Work � <br /> i <br /> i <br /> iProposed Use o►Buildina Contad Person fPlan Reviewl � <br /> � Square Poolage(If resideMial new consWction, remodel or addition) I <br /> � � <br /> i Number o(Aevices pf law vdta9e) <br /> i <br /> � Desaiotion ol Work lo Be Dorre: �N ��nl.�— � G�"'' 'M�'` L" �1 � J L� ' <br /> i ` <br /> � . . <br /> � 1 � i i <br /> I CRY OF EVERETT LOCAL SALES TAX CODE IS 3105 I �� • !^ D � <br /> V <br /> � J ABreDy ceRily fhet 1 heve read and examined fhis applicab'on and know Ihe same fo be frue a� � <br /> � Conect. All provisions of laws and ordinances goveming this type ol work wrll be completed <br /> whefher speafied herein or not. The gran6'ng ol a permit dces not presume fo give euthority fo PERMIT# <br /> violefe or cancel fhe provisions ol any other stafe or local law repulafing cunsfruction or fhe <br /> pCAormance of conshuction. That f am authorized 6y lhe owner o/this propeRy to peAorm the E ���j ��– b t-f C' <br /> Iwnrk ch applicallon is made d 1 comply with tAe Sfate Conhadors Law 18.27 RCW end <br /> 29 .20 A . � � <br /> 1 � <br /> i <br /> � SignaNre Date � <br /> I <br /> 1, � <br /> t <br /> 1 aEYISEDYN'�] � <br />