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_ � _ � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �v�s��� I <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> E � �( p�l-b�� , <br /> � � 3/ f Ma�'i ,vr v, E� /�>2 co-rH-�F � <br /> �f7s'gss- �as� <br /> PROJECT ADDRESS <br /> �✓�ti'rz� <br /> �o� r2T � �; ie��- Lr lloi�- l9'� iW� SD Su r�s 6-/S`f W� 9b�o� <br /> Ownef h7ailAtldress Ciry Slate2ip Phone <br /> �o7-riu,:. (� <br /> (jAf�qn2P H /1rG'�r�i �L l23! F r-�A,2�..» v.cw De FvNzn•r w/� �F3o& �ti�s)�i9- /GS'l <br /> Tenant MailAddress City Slale2p Phone I <br /> � r��F <br /> Eleclrical Contraclor Mail Address Ciry Sta�e2�p Phone <br /> State License Number(required) City o(Everelt Business license Number(required) <br /> I <br /> �ZESI D�i�T� R-t i <br /> Proposed Use o(Buildine� CoNracl Price of Work <br /> 1203��— ils �cwca vas 38s- eai I <br /> Square Footage Qf residential new construction, remodel or addition) Conlact Person/Contact NumbedEmail N o� , a.,. <br /> r o �.-.-t _ r _ r S� C�i {'A <br /> N �/-} <br /> Num6er of devices(If low vollage) <br /> Description of Work to Be Done: ��r P�/a�F �7�T6�' g�YS� — <br /> FEE � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �5 0� <br /> 1 hereby certify tha(I have read and examined this application and kno�v fhe sarne to Ue frue and <br /> correcf. All provisions o/laws and erdinances goveming fhis fype ol work�vill be compie(ed <br /> whefher speci(ed herein ornot. The granting ol a permif does nof presume to give authonty to PERMIT#1 <br /> violafe or cancel the prnvisions ol any other s(afe or local la�v regulating construclion or the r I �O (� _ OQ � <br /> perfonnance ol construclion. That 1 am aulhonzed by Ihe ownerol this propedy to peAomi fhe C � � <br /> �voik/or�vhich applica(ion is made and I comply wifh the Stafe Conlrecfors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> �� �� ��S//� <br /> c�i9�i a���e � _. Dale <br /> PEVr5E0 os9W10�+ <br />