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ELECTRICAL PE�tMIT APPLICATION <br /> CITY OF EVERE'fT PERMIT SERVICES <br /> 3200 CEDAR Sl REET, EVERETT, WA 98�07 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org .�_��— �l� <br /> ' C:�/y6 ,��04v <br /> 1.3c.:U N/k r r i I I Crp e� ��x�U # � ��� <br /> PROJECT ADDRESS <br /> Owne� MailAtltlress Ciry Stale/Zip Phonc <br /> �e,�r�I �-f-�-s- <br /> �G�lac ���a�� b3cw c,�r,�.kPV,��]fl.r� ��f�- �0�3 zia-3�y <br /> Tenant � � htail AdOress Cily Slate/Zip Phone <br /> �� <br /> Pro���i 1 �o�� Le9�`^ �1Ue SF�tA- I�,c�}4- u1�- 9'��- 398-�os� <br /> ElectricalConlraclor MadAdtlress C�ry StalM2ip Phone <br /> P�o�"Eo��33 P��P �/,`f��— <br /> Stale License Number CoNract Price of Work <br /> 2-s3 39 S I o <br /> Proposed Use of Buddmg � Conla t Person (Plan Review) <br /> �/A _ <br /> Square Footage(If residential new conslruction,remodel or addllion) <br /> _� <br /> Number of devices(If low voltage) <br /> Descnption of Work to Be Done�. � I� r� 1 <br /> ' ��i r00vV1 ��x,IS� -1�t� V�f�rkn wV'•iih C�S�V��`�. <br /> �f���� � I V�J� R�i 5�-i✓� n �f SS ��l�-ro� i�v�., • — <br /> FEE <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 '�D -W <br /> I hc�eby ccrti(y Iha(1 fmve rcod and ezaminr.d fhrs applrcahon nnd know(he sarnr, fo 6c Wc and � <br /> conecf. All provisions ollaws and ordinances goveming fhis fype ol woik wdl be complefed � <br /> whethcr specdied hereirr or nol. 7he gnnfing oI a pemiif Uoes nof preswnc fo 9ive authori!y lo PERMiTtI / <br /> vinlale orcancel fhe pmvisions al any othersfale nr lor.al law regulahng r.ansUuchon or fhe /� 'f/'(i� _�71� <br /> perfomiance o'cuns6ucfimi. Thal 1 am aulhorized Gy the owner oI this prnpc�ty lo perfonn fhe E (� �T�� V <br /> �vork for whicb:.pplicafion is madc.�r�d r�o���ty w�u,rr�c sr��tc Confiacfors La�v 18.27 RCW arid __ _ <br /> 296.200 WAC. <br /> �a���y�=�t �` /� <br /> /�9gnalure . ate <br /> �/ <br /> HCV6EDlROnI <br /> ) <br />