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_Pe� _ ,�a� <br />�����+e� <br />�/i�/�3 <br />i�su-e� <br />, � <br />�� �' o��, U <br />�� ���°��' ��.ECTRICe4L PERMIT APPLICATION <br />�P -�`�'t:�`' CITY OF EVERETT PERMIT SERVICES <br />��� �"� 3200 CEDAR STREET EVERETT WA 98201 <br />(;��Q� <br />�1�` 425-257-8810 - FAX425-25i-8657--wv�nv.everet�wa.org <br />�2-�`.� ��,�-i0 ,cQ� �� <br />PROJECT ADDRESS <br />` �P-�-� �Y� ra� <br />Owner <br />trta�l Address <br />Cny <br />'�`l�`l� <br />� / 3L'8-c�L <br />��f�- ��'2�3 <br />SlalelZ�p Phone <br />��.C�l'N �'i — <br />Tenanl �dailAdCre55 City SlateZp Phonc <br />��—�����/d�'l �ZJ 1�� %D� ���'� ��'d �{ � <br />E�eci�icalCon�ractor lda�lAdtlress Cd StatelZ�p P�onc <br />1 �jZS � �6�-z <br />! � l%� S�lo�' � `�c� <br />State Gcense Number Contract Price o( Work <br />�,,OILEI� - Cil � G't;�-�CQ7� <br />Proposed Use ol �uilding Contact Person (Plan R�Jiew) _=� (� ' A.� <br />y <br />Square foolage (If residenGal new conslruction, remodel or addilion) <br />Number of devices Qf low voll2ge) <br />Oescriptian o( Wark to Be Done� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceRily thaf I have mad and ex�mined fhis applicafion and kno�v (he same to be frt�e and <br />conecf. �ll p�ovisions ollmvs and ordinar.ces goveming this type ol work �vill be cornpleted <br />�:hefher specified herein ornoC 7he gnnGng ol a penni( does noi pmsume to give authority fo <br />violate or cnnce! (he provisions ol any ofher s(afe orlocal law regulating constnrc6on or fhe <br />peAomiance o/ consfmclion. T"haf I am authonzed Uy Ihe owner ol this property fo peAorm the <br />wo w u appfiwli mad co Ihe afc Contraclors 1 3�v 18.27 RCW and <br />z zoa ��� ����3 <br />�:�visen i:m» <br />FEE <br />�0 � 06 <br />PERMIT� <br />E l`�C6�0�?, <br />lU� <br />