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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> .25-257-H810 - FAX 425-257-8857 —www.everettwa.org <br /> �1�._J/�1/T7�' /�1�E, <br /> PROJECT A��ESS � ��E ` `} pQ�( 25g 9�g <br /> /. . <br /> �ovELt��� � �� H i Ct/EQQT ��r- /o <br /> Owne� hlail Atldn:ss Gry Statel2ip Phono <br /> S�/!t0 Q'�!/ L�e�GQOfJ�C� <br /> Tenanl Msl Addres, City StalclLp P�n3 <br /> S/L�.7 <br /> ��s,o,� �Q« G�uP1.���,�� u1�- �� ���-s�� <br /> Electncal Contractor Mall hdaress Gty SlatelZip Pnono <br /> �e��i�G 9�9 Pl+ �G�50, e� <br /> State License Number Conlracl Price ot VYork <br /> o�� ,��lu�Aau,e��J <br /> Proposed Use of ailding Contacl Person (Plan Review) <br /> Square Footage(II residenlial now construct�on,remodel or add�Lon) <br /> Number ol devices Qf low volla9e) <br /> Descriplion ol Wark to Be Oone�. �h�10I�E��6�OG�7� ���/Q,�(L/r�QQ � <br /> �-J�rS �S`�t,��p�7�i � f}CL►OrIA�ZDt�i1-T���4�Ta�c1 D � ._, <br /> �W�Cr/YI9C/I/N�s -- <br /> F�CITY OF EVER[TT I.00AL SALFS TAX CODE IS 9105 /2�. ��� <br /> 1 hcmGy ccrtdy fhof 1 have maAand exammod Ihrs app6cafion and kno�v the samr,to br, truc anA , � 7 '� <br /> correc(. All provisions o!lnws nnd ordinanr.es goveminy Ihis lype of wo�k wdl De compleled <br /> whelher specifieA hernin or noL The gn,nfing n/a pr.m�if dons nof pmsurne fo give aulhonty fo PERMIT# <br /> violofe o�canr.cl fhc provisions olony olhr.r sfatc ur focallaw m9ulafing consln�cfion or(hc r ^ <br /> pcAonnancc consfnrcfion. Thaf 1 am authonzed by fhe ow�nerol fhis property fope�fonn the t (�0�� '�1� <br /> woik!or whi epp6cnlion i r a[le m 1 r.nmply wilh Ihe Slafe Canfrncfors I.nw 78.27 RGW and �� <br /> 296.200 W . <br /> 9�� �� <br /> Si9nai Dalc <br /> r+rv�s�n.l^.oin <br />