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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT FERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257•8810 - FAX 425-257-8857 — www everettwa.org <br />.��� 31 �c,G,�i,/,� /�. <br />PROJECTADDRESS <br />%.-,�,s �.5�x. .� 3 �- �G�G � �P�.i�' <br />Owner 6�ad Adaress Cny <br />Tenanl <br />///a1xvG f <br />EleTdncal ContraC.cr <br />IdaJ Atldress <br />� <br />1.'a i :�ea�ess <br />f y.�i1o��= l :'o� �c. <br />Stata LicenSe Number <br />Use a( Bwid�ng <br />Cay <br />� � �✓.�� ,�/�. <br />uare Foolage (IF residenUal new construcl�on, remodel or add�honl <br />Number of devices pl low <br />/2.-�-/�j <br />� 1312 -176 <br />L %�.Zc/ <br />Slate2�p R�one <br />SlatelZ�p Pnone <br />��� <br />C1y Stalc2ip Phone <br />_L=b� �l.�'O <br />_�d� <br />Conlraq Pn; c o' Work <br />Descnp6on o( Work to Be Done �5��/,�2r,�. !�' <br />�'---- <br />� 2o ar��P cn' <br />�- <br />Contact Person IPlan Fev:ew) <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 �%�w <br />I hereby cerlity fAnt I have rcad and ecarruned thrs opplicalion and hno;v thr same lo be fine ��id __ V__ ___ _. .____ <br />correcf. All provis�ons o! Ia�vs and ortJmantes Ooveming lhis fype ol w.orA �vdl be r,ompleted ----- <br />whether speafred hercin or no( The gnnting ol a pennR docs nof prrsurne fo 9rve eufhonty fo PERNIT� <br />viola(e or cancel fhe provisons o/ any other SWte or local la�v requlahnq consfrt�r.t�cn or Uie ^ I` I^ _ I� / <br />pedom�ance o/conslmchon Thaf 1 am aulhonzed by (he ownei o/ this propeRy fo perfo�m fhe t J L 4n <br />wo�k lor which ap icafion is made and 1 compty wilh Ihe Sfale Confracfors La�v 78 :l HCW and _ __ <br />?96 200 WAC <br />/ �� /����3 <br />_. __, ,-,� �, <br />