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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 6 � ,s ay <br /> 3200 CEDAR STREET, [VERETT, WA 98201 �/ yOb � p97 <br /> 425-257-8810 - FAX 425-257-8857 -�w�rw.everett�va.org <br /> � S'� .��� � � <br /> C� 0 /`� �� ��- � � �, v-e ��2 P�� I< �,.�ti � <br /> PROJECT ADDRESS <br /> �-- <br /> 1 ���, ��� P y2 s- sy- 3 7� <br /> Owner h7adAddre;s Gty StatelZip Phene <br /> � �oG - y9�/ - 1 7�- <br /> _/ .��� -��.,�,,. �. <br /> Tenant Pota�lACdress Cdy State2�p Ph nc <br /> � f, l >OZZ n , ��1/2{5-��3 S °� <br /> `ti 1=�r�f v,i� 3 s f� /4•.-�c (�� �.r� M�-.w o e�C W/t �_�D d� <br /> Elecirical CoNraclor tdadACdress ci�y � 5 teiZ�p_ � Phane <br /> ��� <br /> �� ,v�� z 9 /� Q3 ��" _- - <br /> State License Number � Contracl Price of VJork <br /> > "C ��I��i ✓'Q �JTi"1� �'f Pi / `-_ '< <br /> Propos se of Buildmg Contact Person (Plan RevieN <br /> Square foolage Qf residenlial nev+conslruction, remodel or additian) <br /> Number of devices(II low vollage) <br /> Dcscriplion af 4Vork to �e Done: � � �L ��0 // -r'j � � r / �C tG� ✓`-( S <br /> _�- <br /> �r P/r�2- lwl�`'�/' � <br /> F[E b <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3705 �{�O✓ <br /> V <br /> 1 hereby certify Iha(1 have read and examined U�is applicafion and know fhe same lo be frue and <br /> cormcf. A/f provisions ol la�vs and ordinances goveming fhis type ol wark will be cample(ed <br /> whe(herspeci�ed h,emin crnot The�ranlrng of a pemiil does nol presume(0 9ive aufhon�• to pFRhIIT# <br /> vielateorcancelfheprovisionsolanyo(hersfateorlocalla�vregulatrngr.ons'ructienorfhe � I �� / J Dp� <br /> pMomiance ol conslruc(on. Thaf 1�m au(honzed Gy Ihe o�vner o(this property fo pedorm Ihe 1� ( <br /> �voifc lor which app6cation is nrade and I comply�vifh the S(a7e Confracfors La�v 18.27 RCW and <br /> 29�.1�0 wa�. �� <br /> L��Y �- <br /> SignaWre te <br /> � <br />