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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVE�2ETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www everettwa.org `�� ). 5-/ 3 <br /> Gi3o ��./2 / <br /> I �� v'�-t��Cr i c,� G��-C�i� �,�-x�� �-^'�`� <br /> PROJECT ADDRESS / <br /> Si Zx L/OJT .1�JpJ /1�'a .vtc.�-ie-�s:l/� L,r.�C� l��w-�/ <br /> Owner Mad Address City SlatefZlp Phone <br /> s /r�,-� /f� ,�-� �� <br /> TCnBni Mad Address Ci.y $�atc2ip Phonc <br /> I <br /> S��tii�� ��-c �2iG. /clL �l/ ,�t= r,.��d ,,v r��v+w�- ,c.�J 7�G 3�w�.�— <br /> ElecNcal Contractor Mal Address Gry State2ip (t��7� Phone <br /> G��4�V1 u-`— <br /> S�c��i c r� �5 Z c y 3. .S��. � <br /> State License Number Contract nce of Work <br /> E x .S,-�Nb JS� <br /> P�oposed Use ol Building Contact Person (Plan Review) <br /> Square Footage �'�residenlial new conslrucGon,remodel er addilion) <br /> �� <br /> Number of devices(I(low vollage) <br /> Descnption ol Work to Be Donc: T�1 n�'�' �'"� �t���t'� /rGL�fJ <br /> c-� � �� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 � b • Q D <br /> I hereby certily thal l have mad and exanuned thrs apphca6on and know(he same fo bc We and <br /> correcf. All provisions o(la�vs and orrlinances govemrng Ihis type o/work will be completed <br /> whethw specified herem or noL The granfing ol a permil does nof presume fo give aufhonty to PERMR/t <br /> violafe or cancel lhe pravisions o/any other stafe or local!aw regulahng consfn�ction or fhe <br /> perlortnance ol consfruchon. That I am aufhonzed Gy Ihe owner o/fhis property to peAorm fhe E (�v"7- I � + <br /> work for which applicatron rs made and I comply wdh fhe Slafe Confractors Law 1827 RCW and <br /> 296.200 WAC <br /> /�_ i 7 /z�—�] <br /> Signature Daie <br /> FEVISE(`1^.0/U <br />