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G25-152-16G6 Ctd HEATiNG 11�.35 26a m 09-12-?G7a 7�8 <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8610 - FAX 425-257-8857 —wwv+.everettwa.org <br /> � _ �Z -� y <br /> (�024 f�i�,i d-1'�.eU c� �V ���C2� C �Yp9y���U <br /> PROJECT AD�RESS <br /> �h .JGL�CSON1 .�1.1'1l.Qr �i c5 ��'YP� �i 2J `�JI� 1 g3� <br /> Owner Mail AdCress Ciry Stalc2ip Phone <br /> Tenant Mail Addiess Cdy SWte21p Pnonc <br /> Cm !-IPr.c{,nc, IhL � 415 �rz�1u�.0 Ev 9$�� �(2s2591��rd� <br /> Electrical Contraclor Mail Address City Sfate2ip Phone <br /> Crn�ir�-N 877 �r� ���d 9 g <br /> Stale Licrnse Number(requlred) Cily o(Everell Business License Number(requimd) <br /> 2� �� <br /> Proposed Use of Building Contract Pnce of Work <br /> �.�1,2. �t2�J 2� �o��a� <br /> Square Foolage Qf residenllai new conslruclion, remodel or addilion) Q'onlacl PersonlConlacl Num6er/C-mail <br /> Number of devices (If low•:allage) <br /> Description of Work(o Be Done: ( nS�I I 1 U�G{,���_v4��,_QQ.� I v��u� �� `—+� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 r.� ODJ <br /> J --� <br /> 1 hemby certily Ihaf 1 hav�read and examined this npplicafion and know fho�ame to bo We and <br /> co�cf. All p�visions o/laws and ordlnancos govoming fhis typo ol work will bo tamplefed <br /> whether specified horein or noL Tho granting ol a pormi(does nol pmsumo fo give aulbonty fo PERMIT.9 <br /> vialafo or cancel(he provisions ol any ofher sfato orlocal law mgulafing consWction or Ihe <br /> pedomiance olcons(ruclion. Tha(1 am outhonzed by Ihe ownarol fhis property�o pedorm fho E I o — DQ O <br /> work lor whicb applicafion is made and 1 comply wifh the S�afe Confraclors Law 1827 RCW and �� <br /> 296.200 WAC. <br /> 9 1� 1 � <br /> Signalure Dalo <br /> AEv6COCao6.J�a <br />