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EL�CTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 4�5-25i-8810 - FAX 425-257-8857 —wvwv.evereUwa.org 3 ��_� y <br /> [ 1 y03-03 z <br /> � ' {'1��,.���P. �., �le ir W/� 9kZo I <br /> PROJECT ADDRESS <br /> Ownef Mail Address City SlalelZip Phone <br /> TCnan� MailAddress Ciry Stale/Zip Phone <br /> �`�c�';�" Po•"�,xz371 _ �.al�,,.��, C.)/� 9'82�1/ <br /> [IeclricalCoNractor H1ailAddress City StalelZip Phone <br /> ��'�L.�=� R� l�, l �—z�v� - <br /> Stale License Number Coniract Price ol Work <br /> 1 _ /��1 �-J�w1Lt <br /> Proposed Use of Building Contacl Pe�son (Ptan Revle�v) <br /> . <br /> � �}52r� <br /> /�G _ <br /> Square Footage (ifresidential ew c nstruction, remodel or addition) <br /> Number of devices (I(low voltage) <br /> Description ol Work to Be Done: GI�� AI✓c_[. ��P� !� ` YG� ��`-i-� �L �"�"-P�"� <br /> -�'4� l�i�t�C.�—.1�.c�`�?1f.L_�1i'I�S <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 R f�� <br /> lJ V <br /> I hereby certily fhat I have rcad and examined fhis applicalion and know fl�e smne(o Ge(rue and <br /> correcL 1111 provisions o(la�vs and ordinances goveming fhis lype ol wo�k will be compleled <br /> v.�hefherspecificd herein or noL The granting ol a pcnnit does not preswne fo give aidhority fo P[RMTT/! <br /> violate orcancel the provisions ol any ofherslate orlocal la�v regulating conslruction or fbe � I�O� _ �^� <br /> peifonnance olconsfrucfiaa Thaf 1 am au7honzed by Ihe c�meroflhis p�operty(o perlonn fhe /� <br /> work for which applicafion is made and I comply wifh fhe Sfafe Contracfo�s Law 18.27 RCW and <br /> 296 200 WAC. <br /> 3 -7_JN <br /> � Dale <br /> vrviseo vra�� <br />