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-- �' • � <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.everettwa.org <br /> � _a, _� 3 I <br /> C13a3� I �f � <br /> ,.S ��� a C � �,� C. � f12 <br /> PROJECT ADDfiESS <br /> �NS�� �9G0 �,up S� L t/�re7`f" w� ���4/ y�"30`/�G6J� <br /> Cwner Mail Atldress Gty Slate2ip Phone <br /> /. <br /> Tenanl MaJ Atldress Cny Slate2ip ' Pnone <br /> / • <br /> EleclricalConiractor MailAddress Cdy State/Zip Phone <br /> ( G�.� C l�P� /�'� l E � J�/L ���'CX�� � <br /> State License Number Contract Price of Work <br /> �U✓IjC�/�-1 �P:��cL he�U�G��C•.. �%�a•-• (iGs� c���u`" <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage Qf residenlial new construclion, remodel or addi�ion) <br /> Number o(devices(II low vollage) <br /> 2�' � �,� � � � �'�' /�P �' <br /> Descriplion of Work 10 8e Done: /!/(/v//�f iY/� ��f ✓��`< < O G Gttr��u/'J <br /> �<,r�-� i:�S�/�//�, ������f./.1 S�,-�;� -e _ <br /> � FE[ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �d2 50 <br /> I hereby ceriily thaf I have read and examined this applicalion and kno�v fhe same to be fn�c and <br /> ' conect. All provisions o/laws and mdinances goveming fhis type ol work�vill be completed <br /> whefher specified hemin or nnt The granting ol a permif does not presume(o give aulhonty fo P[RMITn <br /> vrolafe or cancel the provisions o/any olh,:r sfa(e or/ocal law regulaling constroction or fhe r ��O� ' �,L� <br /> pedomiance ol constn�clion Thaf 1 arn aulhonzed by the owner o/this properiy to peAomi fhe t `� <br /> work 1or wlrich applicafion is made and I compty wdh!he S(ate Contracfors Law 18.27 RCW and <br /> 296,200 WAC. � __ <br /> i /� <br /> � • ����� <br /> � G Date <br /> � Signalure� ' <br /> Feviser,�co�r� <br />