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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /Q�Gf�--t� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> �/� �0-0.6� <br /> � �� v /Yl �Pr��l I ��re-P� l��Cwy ��e•-e�� l.�!/� <br /> PROJECT ADDRESS <br /> �i7 tP� I G1�U �vJeri� � G'�eel� f �u'y_ ��e�f G+/f� <br /> Owner MailAddress � Cily State/Zip Phone <br /> .�� �e _ <br /> Tenanl Mail�ddress Cdy SlatelZip Phone <br /> �tG�l�� �(,eC�i� C �53 I 13�" �� ne L�-Kc S��hr V���� Qd'2 5 t� <br /> Electrical Contractor Ma�lAddress City Stale/Zip Phone <br /> rJ�l C� �g��O��I r���''�r, ss <br /> Statc License Number(required) City of Everetl usiness License Number(required) <br /> � �r�i��qr� 2 L��p , �� <br /> �/��v u�wcf�.,�, �•-. � a <br /> Proposed Use of�uilding -� � �— Contract Pnce ot Woik o S y <br /> �r2,C r�,,,4C H i� L - 2 b -8 �-v <br /> �2��icuT�(.���ck.s�-. �ef <br /> Square Foolage(If residenlial new construction, remodel or addilion) Contad Person/Contacl Number/Email <br /> Number of devices Qt iow vollage) <br /> Descriplion of Work lo Be Done: � �h�1 f G l /7 // �� Vv/T ��✓���O / ��V/i74 � <br /> l— <br /> iz�v c �ii //e� �,� �go� �•��.� , .Lo r 2 �u� C ,�v�2 <br /> —� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �Q'l � � <br /> V <br /> 1 hem.by r.ertily fhaf I have rcad and examined Ihis applicafion and know fhe sarne lo bc fnie and <br /> co�ecL A/l provisions o/laws and ordinances goveming fhis fype ol wo�t<will be compleled <br /> �vhelher specilied herein or noL The qran6ng ol a pcnnd does no7 presume to givc au(honty fo pERMITtt <br /> violate or cancd fhe provisions o/any ofhr.r s(ate or local la�v regidafing construcfion or fhe r ' � � � , ,1 /,,, 7 <br /> per/onnance ol consfnic(ion Thal 1 am a�dhorized by thc owner o(Ihis property to perle�n fhe C (J K�V <br /> worfc lor which application is rnade an mpty wifh the Sfatr, Confracfors Law 18.77 RCW and <br /> 296.200 W�C. <br /> � . / ,�' - -- !Z�— �— / G/ <br /> Signalure Dale <br /> nr-visro onmr�ni+ <br />