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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT P�RMIT SERVICES <br />3200 CEDAR STREEt, EVERETT, WA 982C1 <br />425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br />��� �r � ��..5_S � /� L --� !'� <br />PiZOJECT ADpRES5 � U�� �'^, n I , <br />V 'VZ��q <br />S'v���u 2��-ic�-,w 3�o ��03 Pt s <br />owne� <br />tdail Adtlress <br />Ci�y <br />El3/o-07� <br />�o� 8`�3 <br />y2S <br />� �� <br />t ��o y <br />Stato2lp <br />Phore <br />R�-� �.v�4 � S��o Z"!3 `' Ss� A� S t,� 1P�,3 yz� yY< 9'�- <br />Tenant MoilACdress ciry S�ete2ip Pnane <br />Elecirical <br />��(��dLP � / y ? l� <br />State License Number <br />�rG l�L}( /Y� <br />Address CRy <br />� �� nc,, o (� u <br />Pro osed Usa o( 6ulldirtg �--� <br />� <br />ISquare Footage (If residenlial new consln,ction, remafel oradditlon) <br />Number ot devicas (If low voltage) <br />Destription oF Work Io Be Done: <br />CITY UF EVERETT LOCAL SALES tAX CODE IS �105 <br />�Y <br />State/72p <br />Phona <br />p2 � a A a,� n{�Ii/1�ri" <br />fy�r.f <br />Contrad Prlce of Work <br />Contac; Person (Plan Review) <br />I he�eby r.ertily fhat I have rend and exnminyd !h!s epplrcetion and know the some to ba trva nnd <br />coirect. Al/ provisions of laws and ordinanees poveming this fype ol work wdl br, completod <br />whethe� specified henrin ornot Tho granting ol a permlt does not presume fo glve p�r(hoAty fo <br />vrolale or caneel fhe provlsions ol nny othersfato orlocal low regulaNng constrUcfion orthe <br />pe�,'o�nance o1 conshvction. That I em euthonznd by lhc owner ol (Ms pmperry ro padorm the <br />worklor wh,jcryepplicafien is made end I comply wifh (he Stefe Controcfors Lnw 18.27 RCW end <br />296.200 VY4L . <br />.�`�rSED'JJCnJ <br />F�e '__ <br />�� 0 a+ . <br />PERMIT# <br />E�3(0-07 j <br />iooi�oo a�zeen bo oa e�oaiioioi <br />