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� ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257•8857—www.everettwa.org �`3A � � <br /> C lun��-16� <br /> 10�21 �j�� J7R SE E�E2Eti,ln/A RSZoB <br /> PROJECT ADDRESS <br /> /�AQk �EKS�/1 (a02f 'J3�JjJr �'� F✓ER6rr lif�� 9��� �fL��Z' <br /> Ownet Mail Address City State2ip Phone <br /> TenaN �/� MailAddress Cily State2ip Phone <br /> n/ oLA(L'NL 3r9 E C�a���N S,- Ecun/f�Nk,v1 (�� Qgu� 3(a0-�y6-� <br /> ElednCal Con�ractor Mail AAtlress City State/Zip Phone <br /> WES"i�5�8�-ZnD z`� � <br /> � <br /> State License Number ontract Price of Work <br /> MARkilS �/,e-r� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> 3Ro. zg sa�+ <br /> Square Footage Qf residential new construdion,remodel or addition) <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done N T L L � `-'o L fl l� �]V�� 0+✓ <br /> �' Q 4� <br /> C�cS�t�� �`'�aF o� ��_ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 � - OO <br /> I hereby certily Ihal 1 have�ead and examined IAis applicafion and know fhe same fo be frue and <br /> wrrocf. Afl provis�ons o/laws and ordinences goveming Ihis type o/work will bo completod <br /> whelhor specifred heiein or nof The grenting ol e pertnit does nof presumo fo giv0 authonry fo PERMIT# <br /> wolale o�cancel tlie provisions ol any olhor sfalo or local law iegula(inq consf�ucfion or fha <br /> parlormance ol consfruclion. Thet(em authorizeAby fhe owner o/fhis propeAy fo pnAarm fhe /n g <br /> woAr lor whicn epplicafion is mode and 1 comply wifh fhe Slafo Conlrac(ors Law 18.77 RCW and � � O�_ � `� <br /> 295.200 WAC. <br /> � Z`� �`� _ <br /> Signalu atc <br /> nrvrsEo.vtai� <br />