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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PER�IIIT SERVICES c� _ l-►3 <br /> 3200 CEDAR STRECT, EVERETT, WA 98271 <br /> 425-257-8810 - FAX425-257-8857 —www.evereitwa.org E�3os�(�� <br /> �' � <br /> �����1 Lo �`f � h S�" ��'e'�� <br /> PROJECT ADDRESS <br /> H � <br /> i�'��r � �ke���� � ��f � Z�%<� ���2 �e�-�- �-;/ <br /> Owner Mail Address City State.Zip Phone <br /> Tenant Mail Address Ciry State/Zip Phone <br /> �I� Itio��e� ���zc-Iricn 4 <br /> EledricalContrac�or�P(viC��'SMailAddress City State/7ip Fhone <br /> �'U f'FCJUES �IS—� � �P�) C9Z? 00 <br /> State License Number CoMract Price oi Work I <br /> 5{-"� <br /> Proposed Use of Building Contact Person (Plan Reciew) <br /> Square Footage (If residential new construction, remodel or addition) <br /> Number of devices (I(Iow voltage) <br /> ��/ �) n ���,, � <br /> Description of Work to Be Done: % 0 jf 1�� 1��/1'(ui' � L l I�G L�'�� 7� n�' n'�� �l <br /> C � t2 C.�_k / � �"I �(,� L(,�/t' ���-t' �-%a" - � c4' / �,ff"'1�f� f ��C�L�I <br /> �'L���CG < i�L%(,�c�- . <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 75 � <br /> I hereby ceAi/y thaf 1 have read and examined this application and know the same to be lrue and <br /> correct. All provisions of laws and ordinunces goveming this type o(work will be completed <br /> whether specilied heiein ornot rhe granting ol a pe�mit does not presume to give aulhonty to p MIT# <br /> violafe or cancel fh�provisions ol any other slate or local law regulating constn.ction or the �� <br /> pe�fonnance oI a�f�swclion. That I am aidho�ized by the ownero(this properfy to pedorm the <br /> v�ork for h1 ch aqplica(ion is made and 1 comply with fhe State Conlractors Law 18.27 RCW and <br /> 296.200 QCi� ; -� �13n5--�o ► <br /> i �: � � � � <br /> , <br /> ��". ,, <br /> y . D le <br /> I <br /> ./, � <br /> ij <br /> RFVI$[D 3/ 13 -- <br />