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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www•everettwa.org <br /> �c� � (�`-�S� ��t � � ��C'' �rP c,� �l` <br /> r <br /> PROJECT ADDRESS �f Z S� <br /> ��� � � - � � � � 339:v117 <br /> Gwner Mail Address Ciry Stale/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> ���, �� � 1�� �������� S72y ly��`'���� ��� i4��C s���,���;.w� yb <br /> ElectricalConl� clof MailAddress City StateR�p � one <br /> '��,���5� 1� �f G � IZ�J �zs5�63T <br /> State License Number Conlract Price o,/f�Work <br /> C�C C �(l� G � i,�;'/�'�/t'jPC, r K 1C �� tC�9�1 /1 e /,. <br /> Propose Use of B ding �f Contact Person (Plan Review) <br /> Square Footage(If residenlial new conslruction, remodel or addition) <br /> I <br /> Number oi devices(If low vollage) <br /> Description of Work to Be Done: / "� � <br /> Z � � o �/( �� � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ���� <br /> � I hereby certily that 1 have read and examined this applicafion and kno�v the same to be tnie and <br /> conEcL A/l provisions o(laws and ordinances yoveming this type o(�vork will be complefed <br /> whether specilied herein ornof. The granfing o/a pemiit does not pmsume lo give authority to PERMIT# <br /> violate or cancel fhe provisions o/any other sfafe orlocallow regulafing consfrucfion or lhe <br /> pcdonnance o(cons(n�ction. That 1 am authonzed by the ownerol this property to pedonn the E l ^�j� � — I S � <br /> �vork for�vhich application is mado and 1 comply wifh the Sfate Contractors Law 18.27.ZCW and <br /> 296.200 WAC. <br /> �� 'J�'����-4 �, z�l_3 <br /> SignaWre Dale <br /> reri�r-osx�i� <br /> �---------- �--� - -- ��--- ---- ----�---- - — <br />