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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 a � a0�.11f <br /> 425-257-8610 - FAX 425-257-R857 -www.everettwa.org � ��b� `�z Z <br /> 6b0� IMLrri�� ��`�eP,IG ��y 0��1 �ad 5l� . t06 <br /> PROJECTADDRESS �Zy 7y.�(3�7� <br /> -T ea ,� 6 60o Nizrn( C��� � #'Kw��(1�rt.7T (,J R- `l�8zo3 <br /> Owner h9ailAddress City Statc/Zip Phonc <br /> I ea� u.� 660o X `�zj- k7z <br /> �/"1�rr�l C�cc� ��f_,J Y �' ,r�� 1,1 A� S8 2 03 7�f7 � <br /> Tenant MadAddress C�ty StalelZip Phone <br /> ��d.�r �`���-�nc, 15ozZ 3sak ,� M �J Lv.�.� •,�oodl <br /> Eleclrical Conlractor ht5!I Address C ty StatelZip Phone <br /> SFNu£f �� 1��1 � 1700�— <br /> Sla�e License Number CoNracl Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Square Footage Qt residential ne�v construction, remodel or addition) <br /> Num6er o(devices (II low vollage) <br /> Descriplion of Work to Be Done: n�A �C� J'�+. �T oD� , D�-� le�� � 9' � Lt• �\�t(,t1Z' <br /> 6 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 ��,� O <br /> !hereby certify that 1 havc read and examined(his application and know lhe sarne to be(rue and <br /> corr^cL �111 provisions o(laws and ordinances goveming fhis tyre oI�vork�vill be comp/eled <br /> whc(h�trspeci�ed her�in ornoL The granting oI a pe�mit docs no(presume to givc au(Ironty fo PERMCT�I <br /> violateorcancellheprovisionso(anyothersfafeorlocallawregulatingcons(ructionorthe � <br /> peAoimance of consWction. Thaf!am authonzed by the c�vnerol this property fo perfomi Ihe � � Q Z— ��a <br /> woik/or�vhich application is rnade and 1 comp/y w�ith Ihe SL3fe Contractors La�v i8.27 RCW and <br /> 296200 WAC. <br /> ��� � �� ZIZ��I�'� <br /> � <br /> Signawre � Da�e <br /> FEl9SED 1?0/U <br />