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- - - - - i <br /> I <br /> � ELECTRICAL PERMIT APPLICATION � <br /> � CITY OF EVERETT PERMIT SERVICES <br /> I 3200 CED�aR STRE[T, C-VL"-R[TT, WA 98201 <br /> 425-257-8870 FAX 425-257-8857 -:'r.�r.v everett�:�a ory <br /> � <br /> j c� yos_ �f I <br /> , <br /> � 30 f�„�.7f 5 � u�-�y <br /> � PROJECTADDRESS <br /> I ���Fe_�.�'�cac.czw�b� ✓ �?�`� ��c.;c���C ��e✓� �� I <br /> OwnerJ A1adAdcress C;y Statc2�p F^ene <br /> -- I <br /> � Tenanl h!adAC�ress G;y State�Zip Pti,one i <br /> , �1 ��rP�cx�e� IrSo3ti�S7-}I� `s4- __�,,a-�n ��_�`a_�'�OII �o�- � �_0"`,8�-� � <br /> IElCcdicalCon�raCtor h1a�lA0dre,s C�P� Stale2�p Fhrne i <br /> ' ������� ��S R rnJ -- -- I <br /> j �t3ie LiCensc PlurnbK Conirad Pnce ol':!ork <br /> I <br /> � — <br /> II <br /> Proposed Use of Build�ng Canlact Person (Plan Review) i <br /> Syuare Foo;age Qf residentnl new conslru.tion, remodcl or addition) I <br /> Number af devices(Il low volta�7e) <br /> Descnplion ot VVoik lo Be Done: _�_Q�,,..��p-/ u_���(1.�fl ` �C-�L–� \+/–�. – <br /> FEE — -- -- -- <br /> i CITY OF EVERETT LOCHL SALES TAX CODE IS 7105 �G� U_/ <br /> , 1 hereGy certdy fhal l havc read and examined fhis apptrca(imr and knowlhe sarne fu Ge fnie and <br /> I correcL �111 pro�asiuns ella�•is and erdinantes governiny(hrslype oI woc4�•.dl be cornpfe(ed — <br /> I �vhr.fher speci7ied he�ein or noL The granfiny cl a pennrt does nof presume(o,rive authority to pER14IT» <br /> v;blafe or cancel ihe pro:asrons ol any orher sfafe orlccal imv regidaling construc6on cr the � � � ��. O, ['1 <br /> � peAomiance olconstr,ftfion. Thaf 1,am autho�ized by fhe o�cner o(Ihis properiy(o pedonn(he `�� –� <br /> I �.�erk(cr�vl��c��,��plic�fier�is niaCe�nd 1 conqily�rdh f1�e Sta(e Ccn(racleis La�v 1 B.?7 RCLV and _ <br /> 2962C0 4YAC. <br /> ����_- -����'�---- <br /> gnature D.�e <br />