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ELECTRlCAL 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 a ` a- o —I�j <br /> E-i �oa �u3 <br /> E m ctvi n�Vi e,c�v D r <br /> I`Zz� 1�,��-��. <br /> PROJEC7ADDRESS ���U 4� <br /> —T'I SD Pr� �R f Y11 L.4� "L"��15 i �L? C�S�1c (7� �S�(�' � z� — <br /> Owner Mail Address City State/Zip Phone �� <br /> S`fiD Yu.q� W�,v'��S-2_ I M ar-h hs m1 �'i cc n o <br /> Tenan� Maill�d ress Ciry SlalMZip Phone �• <br /> t'�•��� S�7 <br /> r'(�Pr�.S I N �I.EC_TfLI �L�� � �,U`R �' � �1��fiT �"1bf� � 1 <br /> EI@ClriCalConlraCbr MailAddress Ciry State2ip Phone <br /> �,�P�.S��'C.�-7 P LT �Z��a <br /> Slate License Number Coniracl Price o'Work <br /> Gc�r�W1�(LIC�l� <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Square Footage Q(residential new construction, remodel or addilion) <br /> Number of devices (If low voqage) <br /> Descrip�ion o(WorV.lo Be Done: ��.�� " 1`' ` 02— ��� �U V N �� <br /> _�T�2 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS .;705 n�o�� <br /> 1 frereGy certily lhaf 1 have mad ond examined fhis applicalion and know Ihe same b be frue and '� <br /> co�recl. All provlsions ollaws and ordinances goveming Ihis fype o!work�vill Ge cornplefed <br /> whefhcr specilicd hwcin or nof. The gronfing ol a pemiit docs nof presume ro givc aufhonty fo P[RM[TH <br /> violafe or r.ancel Ihe provisio!is ol any othe�sfafe orlocol Inw mgulafing consWc(ion or fhe r I�O� ' I I � <br /> peAonnance ol r,onstruction Ihaf 1 arn aulhonzed Ly fhe owner ollhis property lo perinmi(he C <br /> work /or which a icafiq�is made and 1 comply willr fhe Sfale Conf�acfois Law 18.27 IdCW and <br /> 296 200 WAC � J <br /> � �-�`� 2 � / y <br /> Si9n ture ate <br /> uwisro v.�au <br />