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� � <br /> �LECTR�CAL PEF�IVIIT' �►�PiLO�;A�"VC�6� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C[DAR STREET, L=VERETT, �VA 98201 C_I V�� <br /> 425-257-8810 - FAX 425-257-8857 -:v�.�✓��d everettwa.org ✓ OD� <br /> ���� S�. <br /> 1-�3D I ���e i�ON� � � r U�O-�-�-�- <br /> PROJECTADDRESS <br /> c� N � r��rs (-�alf������ ���>> 03 wers� r��. S�� tio�M.s�, <br /> IOwner ��4ad�lddress C�ty SlafelZip Phone <br /> Tenant MaJAddress Gty StatelZ�p Phone <br /> �.��i 5_�I e�-��..� 1�3���'"5� �-►w �� 9�a�;-r <br /> [I2ctricalContrador t:la�IAddress C�ty SlalelZ�p P�one <br /> �-�.� �/ S�� � c/0 O�� —��/�c�C/ <br /> Slate License Number Contract Pcce of b'Jork <br /> Proposed Use of�uildmg Conlact Person (Plan Revieei) <br /> 1130 � <br /> Square Footage Q(residential nev�conslruciion, remodel er adddion) <br /> � IJC�-�- �I-e2wGGf� � <br /> Numher of devices (If low vollage) <br /> Deseriplion of N.'ork lo Dc Dane: __ � P O� �Q �*V W ��/V, / �� �� � ��`� <br /> �i�SGa"P�--��}Ni (�-- C_I4�'�--- <br /> FEE <br /> CITY OF EVERETT LOCAL SAL[S TAX COJE IS 7105 <br /> n5 ° G <br /> 1 he�eby terhly fhaf 1 havc read and examincd(his applica7ion and hnow Ihe same to be(r�e and <br /> correct. A/l provisions o(la�vs and o�dinances goveming(his fype ol n�ark�vdl be cnrttplefed <br /> �vhelher specilied herein or nof. The 9ranting ol a permif dces nof presume fo yive authoritylo PERP1fr•7 <br /> violate orcancel Ihe provisions ol anyothersfale orlocallav:regulaling consWction orfhe I <br /> pedormance ol consfruc(ion. Thaf!am au(honzed by Ihe rnvnr.r o/fhis propeRy(o perfemi!he E � ���'�Q� <br /> work/or�vhich apphcafion is made and I comply�ti-ilh fhe Slale Confracfors La�v 18.27 RCW and i <br /> 296.200 WAC. <br /> �,� �� o�i��-��� <br />