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--- -- !- -- -�-- - <br /> ELECTRI�A� iPERMIT APPLOCtiI ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ,--, <br /> 425-25/-8810 - FAX 425-257-8857 -www.everettwa.org (.� -�.Q:'/_s' <br /> � i�o y-�oZ <br /> � / 2 7 �� �P�/�� ,�e <br /> PROJECT ADDRESS <br /> .� � � �� �� ,�� 9 �� � <br /> �_-��r�r-��c�,� <br /> Owncr Mail Address � City :IaIMl_ip Phone <br /> ���J c'_ L�if f�� ✓- � <br /> Tenant Nlail AdJress City Stalel7_�p Phonc <br /> S��� <br /> Eiec�rir.al ContiaCtor MaA Address City StaIM7�p Phonc <br /> �. <br /> Slate License ��umber(required) GI f Everett �usiness License Number(required) <br /> n J— �J '/r ,S � <br /> /`�+'V"l.�'v[ <br /> Propused Use of Bwlding Contracl Price of Wnrk <br /> 1 �Oz� �=,�,,,, ,S�� -� G �e <br /> � <br /> Square Foolaye Q�residenlial new wnstruGion, remodel or adddwn) Contact Person/Conlact NumbedEmail <br /> Number of devices Qf low volta9e) <br /> Description of Work to Be Done: fL�2-� �_ C'C� �� � N�.. ' ��2 ����� <br /> �/ —- <br /> ; �c�7�.� �� � ,��—.����� -- <br /> FEE - . -- <br /> CITY OF EVERC-TT LOCAL SALES TAX CODE IS 3105 �� �C, <br /> � <br /> 1 heroby certify(hat l have read and exarninr.d lhis opplicafion and kno�v fhe sarrie(o hr, fnie and __.. _ . <br /> correc(. /111 provisions o/Imvs and ordinances goveminy Ihis type ol�vorir�vdl br, complelr.d - ----- — <br /> ivhelhr,rspeci�ed hr.�cin or no(. The 9ranhng o/a permit docs not presume(o givc aufhonty lo PERMII N <br /> vrolafe or cancr.l Ihr, provis�ons o/any ofher state or local la�v regulnting consfn�r,(ion or fbe r � r O I I _ �n� <br /> perinmiance ol constn�cfion Th<V I am aulhonzed by O�e owner o(fhis propmty(o pr.rfo�rn fhr. C � y �J <br /> �-,�o�k lor�vhich applicafion is madr. and I romply wifh fhc Stale Contracfors La�v 1 B.2/RCW and ._-.-- --- --- <br /> 296.200 W/1C. <br /> �,-�,� � ' _ �����- _ � 3 � ��� _ <br /> Signature Dale <br /> nc vi;Fr>nzrt,r,^.o i�i I <br />