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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 <br /> Il`��� ��3 <br /> C i3 / � ���� <br /> �c�� � �z�� k�-�� ���� � <br /> PROJECT ADDRESS „�p6 6Y6 �5�(7 <br /> 7��e � (��� �/"� l3ox � 80,�1 ��71��y � , <br /> Ovrner t.1aJAddress Ciiy State/Z�p Phone <br /> Tenant tdail Address C�ry SlatelZip Phone � <br /> �'+ i <br /> �IPc�;C I�G / o ��6 <br /> �s<u ��� �� 75yg S� 1�0'�' Si SPu � <br /> Eleclrical ConlraClor �dail Aadress G;y Statel:ip Phone <br /> II �i 0 ST � � ���_� <br /> State License Number Contracl Price of Work <br /> i <br /> ' A�I u ► -r� - r�«y <br /> Proposed Use ol Dwlding Contatl Person (Plan Reviev�) � <br /> � <br /> Square Footage Qf residential new construction, remodel or additwnl <br /> i <br /> � Number ol devices(If low voltage) <br /> �� Desciip�icn of Woik �o He Done uCC�Q�� �- 'eC� / �'tS'� G�N<< "I UF 5 �r�`_O'0��� <br /> Y <br /> � <br /> _,L{_�j('cr �c � ,'�I c✓in..� r%� / r-r <br /> fEE <br /> CiTY OF EVERETT LOCAL SALES TAX COOE IS 3105 ��j <br /> I hereGy ceriilylhat I have mad�nd exvmined fhis application and know the same fo be f�ue and <br /> cormcf. �70 prov�sions ellaws nnd orr7irrances goveming fhis(ype oI work�vill be cornplefed —� <br /> r�hclher specificd hercin or noL The gn, nhng of a pernnf does nol presume lo give aidhonty(o PERMIT» <br /> violate or cancel(he provisions ol any ofher slafe or local law regulafing consfrucfion or Ihe ^ I n(� <br /> pedormance o/consWc6on That I arn aufhonzed by the ownero/Ihis property fo perlomi lhe t � � ' — V <br /> �vork!or�vhich application is made and 1 compry with(he Stafe Confractors Law 18.27 RCW and <br /> 296 200 WAC. <br /> ����� l/ y /3 <br /> aignatur Date <br /> pEV�5F0 1?Nt] __________' <br />