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ELEC�'RICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES S,_,a9 —/ 3 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org � / 3O5-_/G5 <br /> i � � l � <br /> ��c��r'� <br /> PROJECT ADDRESS <br /> � x �. ��.. �_ � �a� ��s-�-�y s <br /> ,, ,r,. ,,,.� <br /> Owner <br /> Mail Address Cily SlatelZip Phone <br /> Tenanl MailAddress City StatelZip Phone <br /> c:�,��� 5��� cr�,�-,� u� M�, i,,l�� � ,A_ y���- <br /> Electrical Conlractor <br /> Mail Address City SlatelZip Phone <br /> � eC <br /> ��� � �< <ta� �<> ���. <br /> State License Number Coniract Price o(Work <br /> i <br /> 5� ;.� I� �CT�., � — <br /> Proposed Use of Building Conlact Person (Plar Review) <br /> Square Footage pf resider"al new construction,remodel or addilion) <br /> Number o(devices Qf low vol(age) <br /> i� ��,��r„ � �V1U1� "� TG �' � nv 'n4� In !'��r C. <br /> Descriplion of VYork W Be Done: �= -f,���, / r� <br /> - � �C �� I � l � �-�� ��-owe�C — C �,rc.,, �s �q-��.�t-1 -�L <br /> i <br /> � — <br /> F�E <br /> CITY OF EVERET�LOCAL SALES TAX CODE IS 3105 C���, ( �, <br /> I hereby certity(haf 1 hav^�ead and examined fhis applicalion and know the sante to be hue and <br /> correct. All provisions ollar�s and oidinances goveming this fype of work�vill be completed <br /> ivhether specified herein or not The 9ianling oI a pemiit does not pr�esume lo givc aufhonty to PERMIT,9 <br /> violafe orcancel(he provisions o/any afher sfafe or Iocal iaiv mgulalin9 constrvction or fhe r �—��t�� I r / �� <br /> pe�lonnance ol canstn�c(ion. Tpaf I arn aulhonzed by the ownero/tbrs propeity fo pedorrn the C �[ <br /> work(or�vhich apP�icalion is m�de ar.:11 compty with the Stafe Confracrors Law 78.27 RCW and <br /> 296.2 AC. , ' i <br /> ' �� �� �' �� ��-�� � <br /> —�,;_ . , <br /> �- Signe me � Date <br /> �:i�,�c:�.c,.�� __ _— . —_—_ <br />