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p1/17/2010 OO.OG d3973 P. 001/007 <br /> ELECTRICAL PERMIT APPLICATION <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEpAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425257-8857—www.everettwa.or9 �— t 7 —i y`�7 <br /> � Iy01 �OS / <br /> 3�� 4 �.�4V�" IJ � � <br /> PROJECT AppR�3S /� <br /> y2 �.�a � <br /> ,.pa�-�.a.t�r,� ��a� r�A.v�n `��� 3 � 3 <br /> �e� Mail Addrese dy StatelZip Pnone <br /> Tenant Mafl AAO`ess Ciry SNte(Lp 7hone <br /> �F�`�aun f,( s�� P,o l�or l �Y� � f q'C1n��� ?,SR' ?�(c.� <br /> ElectriralConVactor Ma�iMGrgae Ciry �p Phone <br /> uteu �L�y?� A � <br /> State License Number COMract Pnce of Wotk <br /> �Fh. _ <br /> ProposeG llse of Buildu�g Contaq Person (Plan Review) <br /> Square Footage(If residenGal new conshuC�on, remodel of adAhion) <br /> Numbe�o(devices Gf low vottage) <br /> Description o(Work to Be Done: Tit,}wG �—��1 <br /> �'� C l�� <br /> FE�� p� <br /> cITY OF EV[RE1T LOCAL SALES TAX CODE IS 3105 � <br /> I he�eby cortily that l have read antl oxemined this application end krww fhe serr�e(p pe�e� <br /> cortact. All provisions o!laws nrM ordinances povemirg ttns fype of�yorh wj)�pe aom�yafod <br /> wAether specitied horein or not. The granting al a parmif daes rwt presume fo�ve oufhcriry fu pE�Rp <br /> viola�e or cancal the provisians oI any oMer sfate or 1oc8/lpw reyWetinp aonslyction o�rfre � ���� —O �� <br /> peAo�manco o!cnnshuctlon. Thaf/am euthonzed by Ure qvner d Uris property to perlom�(�p <br /> wnrk lar which applicaHon is meoe and f comply witb!he S7ate Contmctors Lew i8.27 RCW and <br /> 296.200 WAC. <br /> ( � � � <br /> t9nB UIC i <br /> R Sf0YlY17 <br />