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i <br /> � � � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER�/IG,ES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-25T-8857—www.ever�ttw�Arg <br /> ; , _ G-iy <br /> � � ,yo, _�� y <br /> � <br /> 2��1 I��1�� �.��- �,�.00 <br /> PROJECT nDORESS � <br /> �I�� 2'�L��(���,5�� t.i.�k <br /> Owner Mall�ddres3 C�ly I ;Statc2ip ( Pnone <br /> � r��� I 1��I-rn o►?�i�1./pi ��2r�'. CJ�A' q 92a I �0-3�7 <br /> Tenant ��� J MaiiAdtlress Ciry Sutemp Pnonx <br /> v <br /> �'p���1 �aa�5(,a�cu'r�U�I,V� I ',l�e ,� 5o34s�.. <br /> EIP.ctriralCoMractor MadAAArnc< Cy., j/ f.i �Glala/l�� ^�� <br /> �VT { <br /> =r¢r����ac�� (�� —,���+��a� � ���9 <br /> State License Number ontrac�Price o ork <br /> �.�NK.��'M ='� <br /> Proposed Use of Building ConteM PersOn (Plan Review) <br /> i <br /> I <br /> Square Footnge (II residential new conslruction,remodel or addilion) I I <br /> IK� � <br /> Number o�i.tilces(If Iow voliaye) � <br /> Ocscripllon of WurA Iv 6r poilO: �I�Ir3L4..�,1.�,� pj�;�/�D� __ <br /> �..��--- _—� L .. <br /> I <br /> � FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3'I05 <br /> I hemby cemfy fhnf 1 hnvc r9ad a�d examinvd flus epplrceGon and know the same to be truv and � � <br /> coflCct. All prows�ons o!laws antl ortl�nances rJOvemin(�tnls typC o/wdd(wdl(te complefPd <br /> whefher specified herein or noL The grnnting ol e permif does nof presume to giw authonry a ' PERMIit! <br /> vlolaMorCancelfbeprovisronsolonyothcrslotcorlocnllawrggulafingconsirucGonortlie � ' I <br /> pefformence of cvnstructlon. Thnt 1 nm authonzetl by fhe own:ro!tpis properry to pertorm f e I N-O f „O��� <br /> �,-ork lor whlcn appucntlon is made and I comply with(ho Stele Contrncfors Lew 18.27 RCW bnd � � � <br /> 296200 WAC. <br /> ����C� � 4 � <br /> ���9�gnecure ��J Oe /��� I <br /> REViSE017CVU I • <br />