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� -- -- — — - � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I <br /> 425-257-8810 - FAX 425-257-8857 —www everettwa.org <br /> � � I � ������ <br /> PROJECT ADDRESS <br /> I�A�� g�S <br /> Owner Ma�l Address C�ty StatclLp Phone <br /> Tenant MailAtldress Gty StatelLp Phone <br /> ��.rv�M�-r C�F'cs' �-�, 6203 26�st� Sr- Nw S�w��� l•x� �B�i'� � <br /> EleC�ncal ContraCtOr M1'ail Addiess Cuy SlatelDp Phone <br /> y25 3�S 5�5� <br /> 4�r�M Ic-i �Kti _ �Q°" <br /> Sta�e License Number Contract Price of Work <br /> SF ,� , <br /> Proposed Use ol�uildmg Conlacl Person (Plan Review) <br /> 2^�-c�U <br /> Square Poolage Qf residential new conslruclion, remodel or addilion) <br /> INum6er o(devices Ql low volta9e) <br /> Descnption of Wark to De Done� � �'M� Q�f �'1v '� N CV" Jr-�+ <br /> —-- — � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 (-�/ (`� <br /> 1 herr.Gy certily Uret 1 have read and examined fhis applicalion and hnow the serne!o be fn�e and ` D � " � <br /> conocf. All pmvisians of Imvs and ordin�nces goveming fhis fype ol c:orh�vill Ue complefed <br /> whelherspecified he�e'n or noL The granting c�a pemut does nnf pmsume(o�ivc authonty to PERMfTN <br /> violate or cancel fhe p�ovisions ol any ofher sfa(e orlocal la:v reg�daf�ny consfruc6on or the r I ^ O� _D � <br /> pc�fomrance o/ronstnrefion. That 1 am aufhonzed by Ihe o�vner o/fhis propertylo perfonn the C �j � <br /> �•.ork lor�vhrch applicafion is nrade and 1 comply�vith Ihe S':�te Confractors La�v 18.27 RCW and <br /> 296.200 WAC <br /> �N1 � /� <br /> SigRaiurc Oale <br /> NFlio:�}^,l•i —_.___ _ _I <br />