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• o � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 G ..�0'aS �' 1 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �i 5 0 6�0�/ <br /> ln �n �� �PV'U`/ / I �V' e�/�C YG � I�cwG �/�� /Qd <br /> � <br /> PROJECT ADDRESS <br /> . <br /> T��C � nr.�t,R� " G(iln.. � <br /> O�vner �/ Mad Address City StatelZip Phone <br /> ,1L�1� �i(� W�O�/ ! /P�N�`// �Ye.C,� ✓4 �l/fr(.1 / N//! o�o�-qdo -�a8a <br /> 7enam Mail Atltlress c�iy ' sia�e�z��, a06-73p_�5�� <br /> ����'s �/e��� po, ��,� �s� c% �,�G� , ��- 9�a�6 <br /> ElectricalCoMraclor blailAddress C�ry StaleiZip Phone <br /> Ch`F75G '� BS � �T > l� e�e,��Of#v'�/ aoo � <br /> Stale License Number(required) City o— (Everell Business License Number(required) <br /> GU�,�, . G� o.z,�- �� �-�U`_�� --s- `� � � D Q .— <br /> Proposed Usc of Buildin� � Contrac Price o(Work f � r e5 e� <br /> L_G1C - <br /> o?G(o- 73D "�5a'D �o,,,,, �sf_ v,e� <br /> Square Footage (If residenlial new consiruclion, remodel or addilion) Contact Person/Conlact Number/Finail <br /> Number ol devices(If low voltage) An l ,�C C - S f� ��7' fjT �/ <br /> \ (.'_/GC�` � �'t.�S � <br /> Descriplion of Work lo Re �onc: ! � � �/"'�- ` -3/ ]rO � GU �'�'[ �t '^G�� <br /> �-a��_�o /-I.ti.� c ;'�. � �, .'s a ��� �U /� �o ��_ <br /> �v�—o �,— �_� r �/o c �--1�--�'—O'ke___—�r�-� ��-. �`"�- <br /> � � � <br /> C.a r�. v. e �i"o L� FE[ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 l Q � '/ 71 <br /> I Iv <br /> I hereby ccrtily fh�t 1 havc rcad and examined Ihis applicalion and know(hr. same lo bc fnie anJ <br /> correcf. All provisions ol laws and ordinances goveming fhis fype oI wod<�ti�ill be cornplefed ----- <br /> whefher speci�ed hcrein or noL The granGng ol a permd dor.s not prr.sume(o give au(honty fo PERMITJJ <br /> vioL�(e or canccl Ihe provisions o/any olher stnle or local I�w regulafing consfruchon or the r <br /> peAomiance o/cons(�ucfion. Thal 1 am nidhoiired by fhe owner ol this properly(o perlonn fhe t I �D� - b50 <br /> woi}c lorwhich applicaGon is rnade and I compty wilh fhc Sfafc Confractors Law 18.27 RCW nnd <br /> 296 200 WAC. <br /> _�,�/d � � �/_U���- 6 ���5 <br /> Si9naWre ���� <br /> i+r wsen neAcnm+ <br />