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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 `13 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org � —�a <br /> c—�3v�—o�c <br /> —� r �;�. <br /> -=�- �uc; .�;�,-,- ll c�z2�� ��,-�� w y� _��:1� � . <br /> PR JECT ADDRESS I <br /> si o�i �o l,�-�4 `1��75 �i�S�39 s �7 <br /> er <br /> Mail Address City State/Zip Phone <br /> r/''� -lo`I (��.s „s '?30 <br /> -5L ' ��, � ,u�:l ���rs ��-.,<+� ,,,�� 9�. )"�� <br /> � /'?J/)'✓�ac1v�-.H /�.�, C� r�..c." Phone <br /> Tenanl Mail Address Ciry StalelZip <br /> ��nUnfi ��� I �H-�,si <br /> Eleclrical Contrector <br /> Maii Address City State/Zip Phone <br /> ?�LC� <br /> State License Number Conlract Price of Work <br /> 1'�,s� n%S�cy.� `�Sn-32�-`i�9� <br /> ��� �� �� S�' �� Conlact Person (Plan Review) <br /> Proposed Use of Building <br /> Square Foolage(If residenlial new conslruclion, remod�l or addilion) <br /> Number ot devices(If low voltage) <br /> r • ,1� <br /> DBSC(IplI00 0f WOfk I0 8@ DOOB: l��'� �L'C C.n.'�� "'<<ti��P�- 1' .:r-r L ✓�•pi�'� :J✓S u�o i,� <br /> Cil) G. /' CC/)) '•�$SC1' . <br /> FEE <br /> �, `�Z' <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 .}yjC� �LI � � <br /> 77' <br /> I here6y cedi/y that 1 have read and examined this applicafion and Wiow fhe same to be true and <br /> correct. All provisions of laws and ordinances goveming lliis lype o(work will be completed <br /> whefher speci(ed herein or noL The granfing ol a pemiif does nof preswne lo give nufhonty fo PERMIT# <br /> violale or cancel the provisions o/any otherslafe orlocal law regulafing construc(ion orfhe E �,��� _ v 5 I <br /> pedormence o/conshucfion. Thaf 1 am authonzed 6y the ownerof fhis property to pedorm the <br /> work!or�vhich applicafion is made and I comply wi lhe Stete Contractors Lo�v 18.27 RCW and <br /> 296.�04YA . <br /> / , � � �3 <br /> i _ ���,/ —�. <br /> � <br /> r,casen szaia <br />