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i --- �--�--�----- �-- - -- - <br /> ELECT�ICAL PERMiT APPLI�ATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I 425-257-8610 - FAX 425-257-8857 — �v�^rv� everettwa org <br /> li �__ �� Z �(� _S f' _=7 � <br /> `�.'. ,( ve.-e �� <br /> PROJECT ADDRESS <br /> ��r��rves� �i�,�� `G� 3/2 � y�r .�' �c� l/n:� � Ever�/�, Gl//} 9,8Z t��/ i <br /> I Ov:nef P.1ailAtldress C�.ty Stale/Z�p Phone � <br /> iI <br /> I ! <br /> iTenant �+1ail Atltlress City StatelZ�p Phone � <br /> � �U��� � <br /> � EledricalConlfactor fdadAtltlress City SlateiLp PYcne , <br /> State License Number Contract Price of Work II, <br /> Proposed Use of Building Contact Person (Plan Revier+) <br /> Square Footage Qf resdenlial new consiruction, remodel or addition) <br /> INumber of devices(If low voltage) I� <br /> � Descnption of Wark to �e Done� ��« i,�o Gte�� ��/�' �����' "fl �D��� II <br /> i <br /> --- --------- -- I <br /> FEE <br /> I�--- - <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> 1 hereby ceifily fhaf 1 havc read and examined this application and kno�r rhe same to he hue and _ __. <br /> correcl. All provisions o(lavds and ordinances goveming fhis type o(woAc vnll be compleled -- — <br /> whether specJied hemin ornof. The granling ol a pem�i(does nof presume to,qrve aufhonfy lo PERMR�; <br /> violafe or cancel the provisions olany other s(a(e or local/aw regulating consfn�ction or fhe r I �O I ✓ O l � <br /> � per/omiance o!cons(n�c(ion. Thaf I am aulhonzed by the o�•mer ol fhis propeAy fo perfonn fhe C �(Q <br /> �vork Ior�vhich application is made and I comply nafh the Sfafe Confractors Law 18.27 RCW�nd ._ <br /> 296.200 WAC. <br /> ��"� (9 (��—<</ I <br /> S�gnature �a�E �i <br /> . . ..:— �------ -�— -----� --- ----- -- .— <br />