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ELECTRiCAL PERMIT APPLICATION <br /> CITY OF EVEkFTT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 9�9 _,y <br /> 425-257-8810 - FFJC 425-257-8857 —www.everettwa.org <br /> C—��a9 -ds3 <br /> 1309 3�*" �+ Eve�'��� �� q82o1 <br /> PROJECT ADDRESS U�� <br /> �, �5.� <br /> ��c� =>�� s�- ���- ���A ��ao� qo3-���y <br /> Owner MailAddress City Slate/Zip Phonc <br /> Tenant MailAddress City Slate2ip Phone <br /> yas <br /> P ' `1al �ve�'�s4e.� �nol�cxnisl� (,�� �fg2�io c� 3a�-�0 <br /> ElectricalConiracto� MailAddress City Sla':IZip Phone <br /> S�bl�o{tlSb`�,�1 \�-�I <br /> Slate License Number(required) City of[verett Business License Number(required) <br /> � � -- <br /> �^-� ��. <br /> Proposed Use o(Building Cuntract Price of Work <br /> �� oc� S.t�.�� �r�va�! `�2sqo3-OIgZ <br /> Square Footage (If residential new construction, remodel or addilion) Contact Person/Contact N mbedEmail <br /> Nu�(devices (If low�ollage) <br /> Descriplion ot Work (o Be Done: ���Y�n� r A �V""�/��Y' �'L�, <br /> FEE I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �D� <br /> ✓ <br /> 1 hr.�eby ceRily Ihat I havc rcad and examined fhis applicafion asd know fhe samc fo bc We and ___ __ <br /> co�ecL All provisions o/laws and ardinances goveminp this type o1 woik will be complefed ---- -- <br /> whr,fherspecificd herein or noL The g�antiny oI a pemiif does nof prrsume lo give auU�onty lo f p�RMITIt <br /> violafe or cancel ihe piovisions olany ofher sfate orlocallaw regulaling conslruclion or the � � I' r O/� , 0 (�� <br /> peAom�ance of conslaiGion. That!arn aufhonzed by(he owner ol(his property fo perfonn(he �-f ��� ,� <br /> work lor whlch applicalion is made and I r,ompty wilh Ihe Stafe Contncfors Law 18.27 RCW and ___ <br /> 29 AC. <br /> —_— 9/� /LDiv __ <br /> lurc Date <br /> ir[vGc o aav�.vo ia <br />