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. - - - -- - -- - - - - ------- <br /> ELECTRICAL PERMIT APPLI�ATION <br /> CITY OF EVERETT PERM17 SERVICES <br /> 32G0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — www.everetbNa.org <br /> JZ �! �/l .S r _ �STi��ET _ <br /> PROJECT ADDRESS <br /> Cp�NenST.n+= ycH7J nJlr✓LlG 13�05 sr,-r,�'Po�--T QC� D iy��yr����r l.✓q /1S-ILP�,�7� <br /> Owner MailAddress Cily State/Zip Phone <br /> �ienant MailAddress C�ty State2�p Phone <br /> ///%�SEN � �.�r�lt 1'r� //��O �Z 'vy S�fE LN�C JT�r✓G/dJ U//J /O ZS� Y1s-33Y-97 L <br />� ElectricalCoNractor A1ailAddress City Statel2lp Pnone <br /> N�NS<< ro,Z P9 -- °�� °� — - <br /> Slate License Number ConUact Price of Work <br /> S�!` <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage Qt residential new consfruction, remodel or addition) <br /> Numher of devices Qf low voltage) <br /> Description of�Nork lo Be Done: l N S T�JGG l C/'�Pv q yy+�'f ,�C� v(G� <br /> FEE - <br /> ���G iv1 <br /> CITV OF EVERETT LOCAL SALES TAX CO�E IS 3105 � <br /> I hereby certi(y fhaf I have mad and examined this applicafion and hnow tlie same lo bo frue and � <br /> correcf. All provisions o//a�vs and ordinances goveming Ihis type ol�vorlc will be completed <br /> wbefher speci/ied herein ornot The granfrng ola permit does not p�esume fo 9ive au(hority to PERMITlt <br /> violate o�cancel fhe provisions of any olhersla(e orlocallaw iegula(ing cons�ruction or the ""'��/ <br /> performance olconstnic(ion. Tha(I am authonzed by Ihe o�a�nero/Ihis property b peAorrn fhe E � ���—�Q y- <br /> �vork tor which applicafion is made and f compty wifh the Slate Confractois Law 18.27 RCW and � <br /> 296.200 WAC. � <br /> _ � - ��z6�iy f '� <br /> 1�I �1' <br /> Signature Dale . <br /> 1 <br />