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i .._ _ . . _.—... .__. . -- - -- — . . <br /> ELECTRICAL PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> ' 425-257-8810 - FAX 425-257-8857 —v�nvw everettwa org I <br /> �i <br /> j 21 � ( L I�{a �- -D9 � i <br /> ; �--�- 2���- K�2 A.� a —� g��� <br /> � <br /> PROJECT ADDRESS I <br /> �,.+��.�R m R�- �s H n W zo, � ���2 �2F rr �A ��l _ i <br /> OwnCr tda�iAddress G;y State2��p Fhone <br /> li I <br /> TBnant IAa�i ACdiess Gty State�ZiD � ' PFcne i <br /> I <br /> � r,�,�.��►� ���ae,c���v P.o. �ox � � ��c�2e�t�- �,.,R �zs-� �� <br /> ` ---— , — 5•atNZi Phone <br /> Eledrical ConiraCtOr dad Fcaress Gty P I <br /> I � <br /> i <br /> _�_5,�� ��3�'-����s- ----- � <br /> � <br /> State License IJumber Contracl Price of Vdo�k � <br /> i <br /> � <br /> Q'S t 0�1^�� � <br /> Provosed Use o(Bmldmy Conlact Person (Plan Rewe�:r) 'i <br /> i <br /> I <br /> Square �ootage (I(residenlial ne�v construclion, remodel or adddwn) I <br /> I <br /> Numbei o(dev�ces(II low voltage) <br /> I <br /> i Descrip�ion ol Work to Be �one R�W 1�E__ L �T_F��__/ � ' ' �__��� zN �_F`�� <br /> ' --L�°rJ�R"'�-- - _ __ � <br /> - - -- - ------ -- - <br /> P[[ I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 bf O�--'" ' <br /> �l _� <br /> 1 hen�by certily[haf I havc rr.ad and crarnineA Ihis npp��c:�6on ond kno�v(he sarnc fo he(me anJ � _ <br /> conec(. All provisions o(la�vs and ortfuionces governmg fhis lype ol�vo�k wdl bc conrpleted --- <br /> �vhefher spec�fied hcrcin or nof. 76e granting ol a permi(does nof prestime to 9rve aufhonty to P[Rt•iTT?1 <br /> wolafe or canr.el the provisions ol any olher slafe orloc��l la�v�egulahn_q construc6on or fhe � I' r O �' O^� <br /> prrfomr,�nce ol conshuc(ion_ 7haf I am iufhonzed by fhe owner o/fhis p�operiy fo per(onn fbe L� �'� I <br /> worh 7or which applicahon is made and I comply wilh fhc Statc Conlrecfo�s Lnv iH 77 IiCV✓ar.J � <br /> 296 200 VVAC. I <br /> ' � -�1i�1Jy__ � <br /> S�gnalure �a« i <br /> =r�•d5LD1:Y❑ . . _ ' '— _. . . . .I <br />