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210 --1 -?.a A <br />C <br />C <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—vnwi.everettwa.org <br />46,02 S 3c-4 AicJI_ q$?D3 <br />PROJECT ADDRESS <br />�4z5 ) <br />MA,Q-71 tJ 5A1212, z%02S 3rd ANC -:2S7-1313 <br />OwnUr Malt Addre.sx City $IOIoZO Phcro <br />Tonard Mail AComss C.ly StatU2lpif: �U• D_ ("! <br />7_.b,pp 0�0G'2.1C YP0 Box 305 it) t F-kMrl-=— WA 98113-051D ?" k( <br />Elect,'cnl Conlmclor Mail Addwsu City $tala7lp Phoro <br />zaPpI-: e sB`i16,j(I <br />State License Number <br />Proposed Use of Building <br />Square Footage (It residential new construction, remodel or addition) <br />Number of devices (If lowvollage) <br />Description of Work to Be Done: V��^'C I <br />20 o anvp , M4VA IXiti eyX <br />ovexhea� 5avice'-�o �2-00am <br />R <br />Contract Price of Work <br />Contact Person (Plan Review) <br />051 2i�,0 <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 4115• O <br />I hereby codrly that I have mad and exominad this application and know tho sumo to be true and <br />conect. All previsions of laws and ordinances governing this typo of work will be completed <br />whothorspocined heroin or not. The gmndng of s permit does not pmsumo to give authonty to PERMTT# <br />violafe or cancel the provisions of any ofhur stale or local law regulating construction or fee / <br />performance of construction. That I am authorized by the owner ofthis property to perform the E I /-� (�2— <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and ✓✓ vv 3 <br />RE SEDa?Orra <br />