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--- �- --- — *--- - -- ---- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -�vww everetiwa.org <br /> � io- 3 �-�3 <br /> . C-�3�0 -asb i <br /> � <br /> roo� -�oi< �� s}✓� <br /> PROJECTADDRESS <br /> -, r � <br /> ���:r.� �TL=N(�C"2. Sw 1- -b .,� n.tJ h•� .{�i/1��rt.�T/ �I/� G/ �r✓ `IZ�fIL .jU`�7U <br /> Owner Mad Address Gty StatelZio Phonc <br /> Tenant Mad ACdress CAy State2p Phone <br /> I <br /> � Q�v�2 <br /> Eledncal Con(ractor Mad Atldress C��y Siale2ip Phone <br /> State License Number Contiact Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> i <br /> Square Footage pf residenlial nev+consiruclion, remodel or addilion) <br /> I <br /> Number of devices (II low voltage) � <br /> IUe5cup6on of Work to Be Done __�I JD�,✓E— i3c rFN�.-! L�i/•[Gt:�j G,G C Rc� F� �? �!�/¢ cw.'c �N - <br /> I �-�pltnF l I(���Jfii "�-�Jt.i �t/C'O� / e l�� l � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 �O . OD <br /> 1 hereby ce�ldy Ihaf I have read and exarnined this applrca6on and knorv Ihe same�o be fn�e m�U <br /> co:*ect All provisons olla�vs and o�d�nonces goveming(his!}-pe ol�vork wAI be completr.d <br /> wheiher specded hc�em or not. The granhng o!a pemut does not presmne to g�ve au(honty(o PER��1TTx <br /> violatr or cancellhe provisions ol any otirer sta(e orlocal la�v regulafrng consfrucfion or fhe ZS/_ <br /> peAormance o/constn�ction. That 1 am airthonzed by Ihe o�vner ollhis p�opeRy fo pedomi(he E � 3� (� � 'f' <br /> a�ork!or whrch apphcalion is made and I comply�tiath fhe Sfate Confrac(o�s Laiv 18.27 RCW and <br /> 296 200 WAC <br /> �� I ��/��.�1/l. � �n�3� Zo t '� <br /> S�gnaWrc � - Da c � <br /> I <br /> � <br /> Fcvi;ro�^a,i� I <br />