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�--- � -- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-J810 - FAX 425-257-8857 —www.everettwa.org �`�g.—iSG <br /> �i c�o�._/�� <br /> (o30c� \"(lQse�\\ Cs� �A�rkwa�C.=\o0 <br /> PROJECT ADt7RESS <br /> Owner t�1ail Atldress Gry Slate2ip Phone <br /> e-�ub <br /> `,����ec..�ov��cs �30o VV�ccc�\\ Cc`�`�Av�cw��.���oQH Wc�9�sZ5�3 V2S '�yq-�1 0 <br /> Tenanl MaJ Add�ess Cdy State/Z�p Phone <br /> v. �l.n.c� �c ,c �o �x�1`3�1a ��eG� �,,�c� q�,wy ��2s�aD z�o <br /> [IeclriCal Coniractor Mail Address City State/Z�p Phone <br /> -=CNN o U E� oSSKE ��59�,00 <br /> State License Nwnher CoNr c�Pnce of Work <br /> Proposed Use of�uilding Con�ad Person (Plan Review) <br /> Square Foolage (If residenlial new construclion, remodel or addihon) <br /> Number of devices (I1 low vulla�e) <br /> Descriplion al Work to Be Dane� _�V\SJ(�_�� �- �Q�`�Cn�Qc� �� (�V.�� �2v V <br /> cv,�. �. �co�.�a��s �v�s�J1�e1� CC�v�`�� <br /> I-L[ <br /> - --, <br /> CITY OF EVERETT LOCAL SALES TAX CODE 151105 �j � S(� <br /> I he�r,by cc�G/y Ihaf 1 ha.:�ead and exanuncd Ihis application and know the sdmc to be lrue and O -----_------- <br /> cormcf. �0 p�ovisions ollav�s anJ oNinarir.es governiqg Ihis fype o/wnrh wdl be comple(ed -- <br /> �vl�elher 5pecilrcU hcrcin or noL T�Irr, yranfir�o(a pemii(docs nof preSurne fo give au(honty fo PERMITaI <br /> violafc or canr.r.l(hc prouisions ol any olhcr sfafr. orlocal la�v rcyidating consfn�cfion or Ihc � I � O^ ' r� ^ <br /> pr.r/amianr.r, o/cons(�ucfion Thaf 1 am au(honrr,d by fhe n���ner o!fhrs properfy fo peifortn the ( I O <br /> �vorfc lor whrch app6cation i;rn;ide r+nd I r.omply wilh7hc Sfatc Conlractors Law 18.2717CW and ---.— - - <br /> 296.200 WAC � <br /> S�i a�uir Date ���,� , <br /> rn-:n�v�i.i� � � <br /> I <br />