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�- --� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C ���_�S <br /> 425-257-8810 - FAX425-257-8857 —www.everettwa.org �, /6/ <br /> � �I5�5 � <br /> I <br /> � /S3o /'. htw�,ae v�ew ,��:� � /3 � �IG a 1 <br /> PROJECT ADDRESS <br /> I Pa�� �� S���A Po t�x �59 �urueG,—r �v� 1�6�20 6 <br /> Owner I.tad AOdress City State2ip Pnone <br /> �tr S�w�,�aoks2 Pn �,�a is� C,;,�..�«� <br /> I Tenanl 1.1ad Adtlress Gry State2ip Pnone <br /> � <br /> ! �Y�41L EL.ELT1QlL �40f9 l�'�L{�D�LGNLL A✓fi FU.:QiV� �✓1F �S{71?1 �/]f'75�-�7/JD <br /> Electncal Contractor �,fad nadress Gty S�ale�Z�p Pnone <br /> I i��4NL�E� �11LQ� � � � Q ��i <br /> State License Numbc(reqwred) Gty of cverett�usiness�,iGense Number(requved) <br /> �oo� <br /> PropoSed Use ol Bwlding Contract Price of Work <br /> (�Nu ST�VEAlS �LU 'L�eI -OSII <br /> ds�evchs @d.c.l,l�lcctric.ca:,� <br /> Square Footage pf resident�al new construcUon, remodel or addiGon) Contact Person/Contact NumLedEmail <br /> Number o(devices pf low vollage) <br /> Descnpt�on o1 Work to Be Done. � �� C��GvL� � �D� JF_ G vLs= �'i Y ����C��j S <br /> - - - - — _ __ . _ FEE — - <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 . . ._ . /no S� <br /> L�/ <br /> __. <br /> - - - - —f�herebycr,Rilyih3f I-have�read-and-exammed(Ns appl�cation and kno�v�the sarne to�be frue and-------�----��---�----'— � - <br /> conecf. All prov�srons ot laws and ordinances goveming th�s lype ol�vork wdl6e completed <br /> whefher speci/�ed herein or noL The granhng ot a permd d0es not p�esume to grve authon(y to PERMIT# <br /> wo/ate or cancel the provis�ons ol any ofher state or local law regulating construchon or the ^ � r O� ! I ! / <br /> pedormance o/consfrucl�on Thal l am authonzed by lhe owner o/flvs property to pedorm the t �_ �U i <br /> work lo�which app6ca6on is matle and I r.ornply wifh fhe Stafe Confracfors Law 78.27 RCW and <br /> 296 200 <br /> � �- �= �F� � IS' <br /> _ � � <br /> ignature ^ate � <br /> IaR��SE�Gs9f.4o�a <br />