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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.everettwa.org <br /> ���D-13 <br /> C-i 309-��3 <br /> ��1� � � <br /> PROJECT ADDRESS <br /> L.�� �,����50.� �113 �-�-ti.5-�-, �i��� Gl 1�9'$� I <br /> Ownef Matl Address City State2ip Phone <br /> Tenan� ��lailAddress Cdy Slale/Zip Phone � <br /> ��,�, ^l _ 5� f� uf��9�C�s �� <br /> � � ' ��1�. Ih�zS ��3� -�, �- <br /> Electn I ConlraClor MaJ Adtlress Cdy State/Lp Phone <br /> -C.N v <br /> State License Number Conlracl Price of Work <br /> GJ��q�� ��2��� f��ic�l�.�� P ��'i — <br /> ProposeJ se of 6uilding Confacl Person (Plan Revie�v) <br /> I <br /> i <br /> Square Foolage (If residential new construction, remodel or addilion) <br /> Number of devices (If low voitage) <br /> Uescnption of Work to �e Done: \�1 1 _ /����V G�`"�.7������ <br /> ----------- I <br /> FEE <br /> CI?Y OF EVGRETT LOCAL SALES TAX CODE IS a105 �� <br /> 1 hc�ehy r.eRify fhaf I have�ead and examined(his applicalion and knoov fhe same lo be frue and ___.____—__..--- <br /> cor�er.l. All provisions allaws nnU ordinances goveming Ihis fype ol wodc wdl be compfeted --- — <br /> whefher specilied hcrein or noL The granfing ol a pemiif dr,c;no(presurne fo give autho�ity(o p[RMCTN <br /> violafe or cancel fhe provisions o/any other sfale orlocal law iegulafin9 r.onsl�ucfion or lhe r I JO� _ I I -�j <br /> perlornrance o!consfrucfion. Tha!I am aufhonzed by the owner ol fhis property(n pr.rlorm Ihe t <br /> woik lor which appOca6on is made anrl l r,onrpfy wilh fl�e Slale Gonfiaclocs La�v ifJ.'17 RCW and _ —_-----_--_ <br /> 296.200 'NAC. <br /> ,tf\ _�!—�`L����--_� <br /> Sigr � _—_._ __ Dalc � <br /> I. . m��i 1U7?mrJ ... .. - <br />