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— -------- -- ----- � <br /> ELECTR�CAL PERMIT APPLICATION <br /> CITY OF EVERETT PERPJIIT SERVICES I <br /> 3200 CEDAR STREET, EVERETf, WA 98201 S `g—/3 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> G � 305-0�17 I <br /> �,5�� I �� ee_ �� <br /> PROJECT ADDRESS <br /> .5cr�� S M. r�� � � LtiC,�'�.-�� � �1d5 - f�(d.8i `,' <br /> Ownef hlail Address City StatelZip Phone � <br /> — I <br /> Tenant Mail Address City StatelZip Phone <br /> l�c�.�c,S�� t�c,F,��. �3\U`t \�`� 5+ •U� la�c���1c. �����s �� �r8� �ras� �a- <br /> I +y$ <br /> Eleclrical Coniraclor Mail Address Ciry Slate/Zip Phone <br /> l,.)C�C^�r �SV"�\Or (� �� �OC�.�>o <br /> S�ale License Number ConUacl Price of Work <br /> � . L��'SGJ� I <br /> �.J..'�c�C_ \'i. �,�� ��,��L�. �0��\ .�'l i <br /> Propos d Use of Building Conlacl Person (Plan Review) <br /> � <br /> Square Footage Qf residenlial new consiruction, remodel or addilion) <br /> Number ot devices(If low voltage) <br /> DescriptionofWork�oBeDone: / '1��'�"' ��� �`��� ���J�Le' I',I <br /> I <br /> � <br /> � <br /> � <br /> FEE <br /> �I GTY OF EVERETT LOCAL SALES TAX CODE IS 3105 � -�j � f� <br /> i l <br /> i I he�eby ce�irly fhaf 1 have read and examined Ihis t�pplication and knmv fhe sarne(o Ge tnie and <br /> ' carrecL All provisions of laws and oiUinances yoveming Ihis type o/�vorh�vill be completed <br /> � whetherspeci/ied herein ornoL The granfing ol a pemiit does not presurne(o give authority to PERMIT# <br /> '. violate or cancel the provisions o/any ofDersfate or local la�v regulating cons6uction or the ^ � ?�, ' I �J`(J y � <br /> �� pedomiance ol constn�ction. That 1 am aufho�ized 4•y(he o�mero(fhis pioperfy to pedonn the C � �'(' v"� ( <br /> � �vork lor�vhich application is made and 1 comply�vith Ihe State Confracfors Law 18.27 RCW and <br /> ��I 296.2�W.4C. i <br /> � _ �, �- �c=�`� �,�� �"d � <br /> Signatwe Dale ' <br /> I <br />