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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERElT, WA 98201 L' �-10"�� <br /> 425-257-8810 - FAX 425-257-8857–www.everettwa.org <br /> C�3ou —mg <br /> i . <br /> � �G � �.,� 6 G� � <br /> PROJECTADDRESS <br /> �L •.27/- 56Y <br /> � ��� �� <br /> Owner MailAddress City S(atefZip Phone <br /> �j�L. O <br /> Tenant A4ail Address Clty State2ip Phone <br /> �.SOT ��c i�i� 020/l �.� STS£ �=vQ•�cl�/ w-�h- ^79'/e� �fts SSS•SJY.y <br /> Elec�tical Contracto� Mail Address Ciry Slate/dp Phone <br /> I�Sd fG � y�-G.Lz [3Z / YG�• <br /> State License Number Coniracl Price of Work <br /> �S a -C-c-. c <br /> Froposed Use ol�uildi•ig Gontact Person (Plan Review) <br /> Square Footage Qf rcsidential new construction, remodel or addition) <br /> � Number of devices (It low vollage) <br /> i <br /> , Description o(Work lo Be Done: �l_ti_r t.�4� �lcw. L i1 � w �'� <br /> I 1 � � � G�-( — <br /> 'Le.., r e.�. <br /> FEE <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �C� ����"1 <br /> I hereby certily tlret 1 have read and examined(his applicafion and know'he same to be(nie and <br /> correct. All provisions ol laws and ordinances goveming fhis fype o/�ti�ork will be completed <br /> whefher specified lierein or noL Thc grardir�g ol a pemiil does not pmsume fo give authoiity to PERMIT# <br /> v�olate orcancel the pro✓isions ol any ofhersfafe orlocal la�v itgulating cona�tniclion or fhe �-i � <br /> ' pe�formance o/consWct�on. That 1 am authonzed by the o�vnerol fhis propeify lo peAonn fhe E ( �'� - � 7 �3 <br /> veork Ior which applicafion +s made and I comply wilh fhe Slate Contracfors La�s 1827 RCW and <br /> 796.200 WAC. <br /> �-�G.� _�sr�-- �/– l�—J-�l-�— <br /> '� S�gnaWr Dale <br /> :�r. �.a;,,, ., <br /> I . ' .—____ � <br />