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,- -- - - - <br /> -- - -- <br /> I <br /> I ELECT�tICAL PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 CL=DAR STRE[1', EV[f�ETT, W,4 98201 <br /> 425-257-8810 - FAX 425-257-8857 - wv�v everelhva org <br /> I <br /> � /�� � �� �. . <br /> � �� �� <br /> I PROJECT ADDRESS <br /> ! �Gl"-_ .���--�'��---- �'`�' --i��� -- <br /> I Ovrner A1adAddiess C�ty Slata2p Phcne <br /> j 7enant L'aAAddrass Crty Siate2��p Phone <br /> ; � �����/�� ����'�/Q,���� ��� <br /> � Flecinc3lCon�r .clor M17adAtldrnss Cny _/��D Statc2p " Phcne <br /> $6G����j � a, <br /> ''� _.�11������ -�--� --- -- <br /> I, �talc Licensc umber Coriract Prlca cl:1'ork <br /> I Propos�se of Budd�ng Conlacl Person �Plan Review) <br /> � Square Footage pf residential new cons(ruction,remodel or addihon) <br /> I <br /> Number of devices(II totiv vollage) <br /> i / � <br /> �� '�Cl= ��� J�/GL'�1�'.� . <br /> Description of VVork to Le Done _ -- <br /> — ---- ��� /l/e.lti�" --- �� � <br /> FEE "--------- <br /> CITY OF EVERETT LOCAL SALC-5 TAX CODE IS 3105 <br /> I hereby cerhly thaf 1 have read and ex�imined lhis apphcation and kno�v fhe same(u 6e(rue and ,__�_____ <br /> cerrec(. 1111 provisians ol Imvs and ordinances governing fhis fype ol��oik n�ill Ge wmplefed <br /> �shether specilied heiein ornot The yranfing ol a permit does nol presume to give acdhonty fo pCRh1ITv" <br /> vrolate orcancel fhe provisions ol any other stafe orlocal la�v re9ulafing cor,struction ar tlie � I �O/ �p��. <br /> performance o/cons(ruc(ion. Tfraf I urn aulhonzed by fhe o�sner ollhis propeRy to perform fhe (p 00 <br /> :�o�fc lor ti�hich applica(' n is made and I comply wilh fhc Sfatc Confrac(ors La�v 18.27 RC W and _ _ <br /> 296�00 WAC. <br /> - �C� 6���__ <br /> Signature Dale <br />