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— —� <br /> 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.evereriwa.org��SD�{ -I b� <br /> ({- ag-IS <br /> I 0 3 � 3 I�^t"' p,�.� S� '�,� re lD� <br /> PROJECT ADDRESS <br /> OwnEr Mail AOCress City StatelZip P�one <br /> �I � r A �1�.�--�� S,�-� - <br /> �� <br /> Tenanl Mad Adtlress Gty State/Lp Phone <br /> l�l/I'Yl � fi��t�� 1 �,5r N�•, ,(�8�n.� W� �i`�001 ZczoS�i29b <br /> EleCtnc21 COnh2dOr Matl Addmss Ciry Slate/Zi0 Phone <br /> �v rv1cU �� � � �► 6� IF �n Ordcess <br /> St te Gcense Number(required) Ciry of Everett Bus ess License Number(reqmred) <br /> ��e l �00 <br /> Proposed Use of Building Contract Pnce ol Work <br /> r/ �LJ�� �lll Il0 2�n ��( Z�'/(p� <br /> Square Foo ge Q!residential new construc!ion, remodel or addrtion) ntact ersonlContact umbedEmail <br /> Ni�mber o evices(I(low voltage) <br /> Descnp6on ot Work to Be Done. �� f�Q � � �� �� � <br /> �e�� , S TU ���Srrn� � �-l.d�� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��j G�� <br /> J <br /> 1 hereby certily Ihat f have road and examined fhis appl�cafion and know tha same to bo Irue and <br /> correcL Af!provisions o!laws and ordinances goveming(his rype oI work will be r,ompleted <br /> whether specified herein or nof. The granting o/a permrt does nof presume to give authonry to PERMIT# <br /> violate or cencel fhe provisions ol�ny other state or local law requlahng construcfion or fhe � J <br /> peAormance o/construcfion. That 1 am authonzed by the owner o/tbis property to peAorm the I /�/i[�-_ I �c/ <br /> work lor which applicafion is made and/ ly wifh the State Contractors Law 78.27 RCW and /U I 0 <br /> Signa�ure Date <br /> REVISEO obD6:Y11� <br />