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L APP �� <br /> E ECTRICAL PERMIT LICATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> �a -�b-�3 <br /> E�� �z -o9z <br /> ��Z� i�i �iG s�'f��f�w9,, <br /> PROJECT ADDRESS <br /> d�f2/ /1���� �ir�G� r�.! <br /> Owner Mail Address City State/Zip Phone <br /> G e ►'�v1 �GIG�� . <br /> Tenant Mail Address Ciry Slate/Zip Phone <br /> SM� �( �tfi��'��� �/�.oG�i� w�/9��fr <br /> ElectriCal ConirnCtor Mail�ddress City Slate/Zip Phone <br /> �7 i'v/�-7��'/ 7�/1� / /%/�i���/ "�`- `�Ii(� L/O 7_v*i <br /> State License Number Contract Price ot Work <br /> '�7Q5 S�, I � �s✓� <br /> Proposed Use of Building Contacl Person (Plan Reviev+) <br /> Square Foolage (I(residenlial new construction, remodel or addition) <br /> Number of devices (If low vollage) <br /> Description of Work to �e Dcne: �/fl� " rF1 t/Ti�/Y�/"JT ?'� ��// lG�/Ld/• <br /> —1 ' , oG / G- <br /> FFE �n <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �O 7 �� <br /> � l, <br /> 1 hereby certily that I have read and examineU fhis applica(ion and knowOie same(o bc fn�e and <br /> conecL All provisions ollaws anJ orzlinances govenrr�y ihis fype o/work will be complefed <br /> whefher specified herein ornoL The granling ol a pemn!does not presume(o give aufhonfy lo PERMR# <br /> violale orcancel the provisions ol nny othersfafe or lorallaw regulating conshucfion or(he ^ I� I Z ' O�� <br /> pc omiance v/cons(ruclion. Thaf 1 am aulhonzed by die owner ol this property(o perfonn fhe t <br /> w rk lor which application is made and I comn/y wi(h Ihe Sfafe Conlruclors Law 18.27 RCW and <br /> 2 .200 WAC. <br /> � 2 6 <br /> Signature Ic <br /> ` ae �seu vtwn � <br /> — --- ---._.—_ '— '—�----- - ---- - I <br />