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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8657 — www.everettwa org <br />�i a5 Ruc.k�4 Pvc. <br />PROJECTADDRESS <br />SNah <br />Ovmer <br />icnant <br />olter 9as Ruc.k� Av� Eve�l. <br />Ma•I Addr�ss <br />M�a nearer.� <br />City <br />cM <br />c,�l� l! -1 7'"l <br />��� as-�� <br />WA `�$dol `'»S 5oi i531 <br />SIa1cZp Pnonc <br />SIa1eZp P'�orK. <br />Sc�l�s �1�c�':c�,� ��tZH N2.5� S� S��oM�sl, wa98a90 `IbS,�3S"Id�S <br />FlcttrtCalContractor Ma1AAE�ess Cny SIaIc2D Phonc <br />so� � - �� s9 a��b <br />St+tc Licenx Numhr.r <br />RL.II S,hj4f, {QMl1,y., <br />Proposed Usr, ol 6wltling <br />10 �o � --�- <br />Square Footage �1f residental new mnstruc4on remc4el r addihon) <br />Nurn6r.r o� Acvircti (II low voltagr.) <br />Descnpnon ot Work ro de Done <br />� +< <br />Coniract Pnu� ol Work <br />ContactPerson (PlanRehewl <br />E�c�}Y;�n�. wi�'i��c� ��� bnlc,h�.ct�'� E <br />CITY OF EVERFTT LOCAL SALES TI1X COOE IS 1105 <br />1 hCir.by certd y(hal l h��ve mad anJ es:)nuneJ Ihr.ti applicahon anJ 6now fhu rame lo be hue antl <br />r.n�mr.l. All provisions ol I;iws :md oidur•inr.cs govr.rmny tlus typc ol �vrok �nll bc cornplr.IcA <br />whelhe� speci6ed he�em o! nol Ihe yranfm9 0l a pennrt does not pmsumr. fo 9rve aufhnnty lo <br />violate or r,anr,d fhe pmvisinns ol any ofhr.r s/atr. nNocal law mgidahng conslmchnn or the <br />perlonnance ol r,ons(nicfron lhaf I am aulhonred by fhe owner o/ fh�s propert y fo peAortn Ihe <br />worA !or which apphc.itinn is madc anA I r.omply wdh fhr. Sfrrtr. Conlmr.lors Law 18 27 RCW nnA <br />296 200 WAC <br />� ,&,al;,, <br />,.,�.:, ���,� <br />��1a�1�3 <br />FE[ � <br />80 <br />PERMIT# <br />E �3II-177 <br />