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-- — --- —�-----—--- <br /> -�- — - -- --- <br /> I <br /> ' ELECTRICAL PERMIT APPLICATION <br /> I CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 987_Ot <br /> 425-257-8810 - FAX 425-257-8857 - www everettwa org <br /> � �oDa 5�� �a �a-7--�3 <br /> �� ��� - � i� iz -i`7�- <br /> PROJECT ADDRESS <br /> Ownef IdaA hddre55 Gty Slale!ZiD Pnone <br /> i �o!-��.. �5(,�s��_� �� I/'�/Ik{e.riu(5 _T,t. y?l�2 (,�;�il( 57�'f" �l.�ia�' <br /> � Ten3n1 b1 :i ACtlress Gry State2�p Pnone <br /> 70G' i�Z - <br /> � �I�,�1f bA cl�c-(�� C�oQ zzy�� s�� ;����,t�� Tc�v�'� ar�h �IKv�3 ����- <br /> IElectrical Contract r 1,1a�1 Aadress Cny State2�p Phcne <br /> ELL��a� /��Q� IZC�.� <br /> Slate Lice❑se Number Contract Pnce of Work <br /> � �?�� ��I, �1�� <br /> P�oposed Use of Bwlding Ccnlacl Person (Plan Rev�evil <br /> Square Foolage (If res�denlial nev+construction, remodel or add�hon) <br /> Nmnber of dewces fll lor�vollage) <br /> Descripuon o(Work lo l3e Done: �"I�'ti� _ � E.'Y����/v L,rJ L����� � i r,.��' C-✓�i--��_ <br /> �-� /.-C�✓ LG'.� ldifl �' uCL'�— � <br /> ��1_ --- ---- --- � <br /> FE[ l <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �I �,��— j <br /> ( I <br /> 1 hercby cerhty(haf I have re�3d anA examined Ihis app�ication and know fhe same fo 6e(nie and —J <br /> con�ecf. All provisions o(la�vs and ordinances govemrng this fype ol work�all Ae completed 1 <br /> rvh_fher specJicd heroin or no(. The granling o/a pemvt does not pmsume to grve aulhonty(o PERh11T# � <br /> v�ulate or cancel!he provisions of any other sfale orlocal la�v regula6ng censhuction or the �r (�I� _' �"] <br /> per!omiance ol cor�s(nichon Thaf 1 am authonzed by fhe o�vner ol fhis propeiiy lo peAonn fhe C 1 �� <br /> �+�ork/or whmh application is made and I comply wrth the Sfate Con(racfors La�v 18.27 RCW and <br /> 796200WAC ��, <br /> � % - <br /> _� i�� ;/ � �1 -Z� ��� <br /> S�gnaW�c �ate <br /> I uewst-oa:o-+, ___ _—_—.J <br /> � <br />