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20 ��'��z� <br /> �-- - - <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 -www everettwa.org <br /> � ����-Iz/ <br /> �t-�oa 1�:�U�ce llR u�rr-i�i �� al —1 � <br /> PROJECT ADDRESS <br /> f ACK VL'R'�RIiL'ti q�104 TCI:RACE I�R U11'I' =1•� �(j�}''TT 1V�\�0; 42i-258-15G7 <br /> Owner n�,�i naaress c�ry State2�p rno�e <br /> Tenanl �.tad Addrcss C.ry Staic2io Fnonc <br /> I �t11 CO�IPORT SYSTE��iS I8103 NF.68TH ST G200 REllAfOtiD �1'A/9R052 425-881-7920 <br /> ��� Electncal CoMraclor h!a�l AdAresi Ciry Slale�Z�p Pnone � <br /> I \1J1COA1JIC925C� �=��� — <br /> State License Number Comrad Pnce of Work � <br /> JANFT CHEI.GREN <br /> '"j�o uu�'1�'101.1.�_ <br /> Proposed Use of Bw'ding Conta:Person (Plan Rev:ew) <br /> � Square Footage(It res�dential new construction, remodel or atltlit�on) <br /> Num6er ol Cevices(If low voltagc) <br /> , Descnption o1 Work lo Be Uone CLLCTRIC ��URNACF: REPLA�:I:A�1GN"1', I.II�I: I�OR I.IRB ANI) _ <br /> [LL•CTRIC Iif:A'1' PU�1P RI:PLACIi\1L•U'I'. LIKG I�OR LIKI:. <br /> — - — I <br /> FEE <br /> CITY OP EVERETT LOCAL SAIES TAX COOE IS 7105 ��`,O V <br /> I hereAy crrfily fhaf I have mad nnA exnrnined(Ivs applicat�on and know(he sarne fo be frve and .__ V <br /> cortecl. A!1 pmvisions o!laws and ordmances goveminy fhis rype ol work wdl be completed <br /> whefher,ry�ecified herein or noL The gnnting ol a pemiit does not presume fo give airthonly fo PERMIT# <br /> viol�te or cancel the mvisions o/any other sf r local law mgulalmg consfrv:tion or lhe l � � ( I <br /> peAomian[e o/cons c6on. That I a �honz e o�rner o/(his property fo perlann fhe E S � I Z <br /> wo�k lor which app0 ifion rs ma and 1 comply w�lb h Staln Contnctors Law 7827 RCW and <br /> 296200 WAC. <br /> � ?119/15 <br /> r Dale <br /> s�.:v�crn . <br />