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----� <br /> , EL�CTRICp►L PERMIT APPLIC.A710N <br /> CIl Y OF EVERETT PERM�T SERVICES �� `� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �1 � 3 <br /> 425-257-8810 - FAX425-257-8857 —ww�r�.everettwa.org � 13��`0�� <br /> �N fiy=[�.c^=i:`> ./L`� <br /> �f <br /> �C�'3c'' 'I�'L ..) L // ' ,�V/: , t;✓( r� 1 � , ��i,� �j�7,,� <br /> '- , ,� � ,r Ave rvC�',� .;r, ,.,� � <br /> �///> 7< < tSZv � <br /> PROJECTADDRESS sfZy 3q�.�/� , <br /> �^v�- /5/C�/,��-'r� 3030 �'cA//O .4Vl_ L- V�i�fi�i�A 9Bz��� , <br /> Owner MailAddress City StatelZip Phone . <br /> Tenant Mail Address �rtY ��a�e2�P Ph���e ,. <br /> � C�L"��'lt".f� �� <br /> � [lectrical Coniraclor Mail Address City State/Zip Phone <br /> � I <br /> I, I <br /> State License Number Contract Price of Work I <br /> ���r-�`/)!ti-'t�� � <br /> Pwposed Use of Duilding Conlact Person (Plan Review) <br /> I I <br /> � � � � Z— <br /> � Square Footage(If residential new construction, remodel or addition) i <br /> ', Number of devices Qf low vollage) , <br /> I Descriplion oi Work to Oe Done: /w �n G'q� C��/��C�L ��N'� L II <br /> �'/�'_c�/,%' �CJTS/7�� �� /�S//� f I <br /> � <br /> FEE <br /> ' CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I� ��� <br /> � <br /> 1 hereGy ceifily that I have read and examined this applicalion and know the same to�:a fnie and _J �i, <br /> comect All provisions o!laws and ordinances goveming fhis type of work will bo completed <br /> �vhetherspecilied herein ornot The granfing o/a pennit does not presume to givo aidl�onty to PER.MIT# I <br /> violate orcancel the provisions o/any othersfate orlocallaw regidating consl�uctien or th� <br /> pedomiance o/construction. That I am authonzed by the owner ol fhis pmperty to perfomi(he � <br /> ivork for which application is made and 1 comply with the Sfate Contractors Law 1827 RC W and <br /> EI30 � - 0�(� <br /> � i96.200WAC. <br /> > <br /> � �/'� ��.,¢-� 7�2 z �/3 <br /> . —7 iqnaiure Daie <br />