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azs7s r ooi/ooi <br />o�iiei2o�a zo oi <br />ELECTRICAL PERMRMiAsE vicE T�ON �`�� <br />CITY pF EVERETT P / <br />3200 CEDAR STREE7, EVERETT, WA 98201 / � 3d 7� b <br />425-257-6810 - FAX 425-257-8457 - www.everettwa.org G <br />� Q (,�/b( / G � � � ��� � <br />.�301 � <br />pROJECT AD RESS <br />. i _ . . .._ ir— � <br />owner <br />Tenant <br />Eleclrica� Cuntrector <br />����� <br />State Liy �se N�mbe� <br />,D cJAI � <br />P�oposed Uso oi �uilding <br />Mail AdCress <br />Nlail AdO�ess <br />DAail/lddress <br />Squaro FootnBe (If residenliai new consirudion, reroodol or addifion) <br />Number o( devices (If 1aw voltage) <br />Uescription of Work l0 8a Done: <br />StotelZ�p <br />��� s3 3 `�- <br />phone <br />Slalell'p � P��ne <br />��� �`"ao �� �rc-� <br />� SWtaJZip Phone <br />ary <br />�ti n �'r � <br />Contrad Price of Work <br />Conlacl Person (Plan Review) <br />; vr� S � � <br />`� Itiu�'_ i 1 � Iv i <br />r "� i�t�I� Clc�i��� <<� <br />CITV OF EVERET? LOCAL SALFS TAX COQ= IS 9105 <br />I hereby ccrtify thaf 1 havo read and oxamined fhls opp�icafron and o; �� W�ll be completed and <br />corrrct. All provislons ollaws And ordinancos govoming this typ <br />whether spccilicd horuin or not. The yranting o� a permit does not pmsume to give autho�ty �o <br />viola(e orcancol !he pro�isions o/ any othorsfafa or local law rogulAfinp construction of the <br />pedormnnco o/ conshvr.tion. 1'haf 1 am aufhonzed by tho ownar ol thls property to peAortn the <br />work (or which licntlon is made and 1 r,omply with tho Sfate Contr�ctors Law 18.27 RCW and <br />z;s.zoo w�% �//�/l � <br />/ _ <br />FEE ,� �� <br />Pl=RM1T# � <br />E �� ' �� <br />-� , �� ,-� �; <br />i ,', ` , <br />f <br />