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� • <br /> -- ---- - - - --� <br /> � ELECTRICAL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STR[ET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -v,n�✓w everettwa.org <br /> (v�a7—�� I <br /> C-iyo6- �� <br /> � �c�7_ �m , -��- ���`-`� <br /> PROJECT ADDRESS <br /> -�-cx.�D � y��ZsS s'/ <br /> N � � �� ��,-� �� c � E� � � � _ _ <br /> Owner ldaJ AdAress Gty State2�p Pnone <br /> I <br /> Tenani hladAtltlress Cdy Slate2lp Phone <br /> �t FQ�I�R� '�'� Ft� ��X T 4v �.t�� �Z�t� �ZSS �' <br /> �2�S�L�L- <br /> ElectncalConiractor i.ladAddress Gty StaleiLp Phone <br /> �) <br /> K�aa -�`C��77 �-c ���0 <br /> State License Number Contract Pnce of�Vork <br /> .�'�-71�1 L( - — <br /> Proposed Use af 6uiiding Ccntact Person (Plan Review) <br /> Square Footage Q(residenli�l ne�•i conslruU�on, remodel or adAit�on) <br /> Number of devices(I(low vollage) <br /> Ocsciiplion of Work to Be Dane _��1��{� _L� 5�'?O W ��1 �� ) � �-�b'�'T <br /> �'1 v.n �`S �,a � �-►-a �Lv O�'��C��l-i_ F�XT��_S <br /> FE[ 7� <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 � In VI ,/�/ <br /> I heret, certdy fhat I have read and r,xarnined Ihis applicafion and know the same fo be true and <br /> � l <br /> conecf. A!1 provisions ollaws and ordrnanres goveming fAis type ol work will Ge complcled <br /> whefhe�specr7ied herem or r.ot The granhng o!a pemnt daes nof presurne(o give aulhonty(o PERMIT« <br /> violate or cancel fhe provismns ol any ofhersfate or locallaw mgulafmg consfruction or lhe � I ��� , I �� <br /> peAomrance o/consf�uch�n. That I am aulhorized by Ihe ownerollhis properiy to pe�lmm(he � <br /> work lor which applrcatio�mad and/compfy�vrth fhe Slate Conlractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Dat� ��-!� <br /> aEvrsc-o v�ar� <br />