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_ � - � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRF_ET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org U`� c�_ r3 <br /> C��u �057 <br /> //l,/�f �� �5 /t�v� Si2 , ST.� /O <br /> � <br /> PROJECTADDRESS /� <br /> /�� / <br /> .fiJ '/�/!- 'y�,�S��°"S i <br /> Owner MailAdtlress Cdy Stale2ip Phone <br /> Tenanl MailAtldress City Slate/Zip Phone <br /> G�.S �G��T� ��� . �a �T�ai3 /��� GU�A 9�5��� �S3 %G�S' �� <br /> Electrical Contraclor � PAailAddress CM1y Slale/Zip Phone <br /> CS��.� s�7� 7��/ �J ���� or� <br /> State License Number Contract Price of Work <br /> �/9L0�7 /��i, �70�5� �S.iG/��� .�� <br /> Proposed Use of�uilding Contact Person (Plan Review) <br /> Square Foolage Qf residential new conslrudion, remodel or addition) <br /> Number o(devices Qf low vollage) <br /> Descriplion of Work to Be Done�. " '��� �J� ��i�� / /X�✓:5 ✓�tL�Sf, `i9�l7yS'i ����CG S <br /> FFE <br /> CITY OF EVERETT LOCAL SALES TAX CUDE IS 3105 /_� � � <br /> l(/ <br /> f heieby ccriily(haf I have rcad and exnnrineJ(his applicafion and I<now the same to bc true and <br /> � correcl. A/l provisions oll,��vs and ordin��nces governiny Ihis type ol wodc wi0 he cornpleted <br /> whr.(lier specilied hr,rcin or nol. ihr, gr,ur6ny ol�,���,n,a doe.s�,or�res��rne m�r�e a�,rnonry ro PERMiT# <br /> v�olate or cancel Ihe provisions ol any olher sr.�te o.iocai i����r���dar��,��o��sa��cno�,or rne � <br /> peAonnance o/cooshuchon. Thaf I am au(fio�ized by(he ov.vierollh�s prope�ty to pedorm fhr. ( �� �— ��', <br /> work lor which npphcafion is made and I comply wdh Ihe Sfafe Conhaclors Law 10.27 RCW a�td ____ __ <br /> 296.200 WAC. <br /> iIil�- `L 5 �� <br /> �� ---` —� -- <br /> i,nalwe Dal <br /> RF WSCU J?WI] <br />