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- �� -� — <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, �NA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —w�v everettwa org <br /> I 7�p a-�3 <br /> ����7 .�ad <br /> � ��fi� �:� � , ,� � r/ <br /> PROJECT ADDRESS <br /> �y����, �i��� s� �����, w�'� y�,_�> y��7�1-�o�� <br /> Ownef P�1ailAddress City State/l�p Phone <br /> TenaM hlailAddress Cdy Slate/7_ipZrZ ✓ / ,p,hone <br /> y � 7� G��" <br /> .��,//�__.in,�'w�i✓��ne� /334�0/�'/�/�-�o� �w,yt�303QM/xi��19,IlG�e�l�/�-�$11J2 <br /> EleetncalConlraclor 1da:iAddress Ciry Siate2�p Phone <br /> �ll��„�� �y�/.� �`���� — <br /> Sta�e License Number CoNr ct Price of Work <br /> Proposed Use of Bwldmg Contact Person (Plan Review) <br /> Square Footage pf residenlial new conslruction, remodel or addilion) <br /> Nurnber ol devices Qt low vol�agc) <br /> . / ��// i <br /> Desr.riplion ol Woik to He Done __N t.�y/_�7V V ��� (��Gl� � N���� �P{,6/ <br /> J"`�/5 <br /> _-1�.w_c dr� GF� /rr� s1�!-���d'�� - -- --- <br /> - � - - — <br /> FEL ---- -- <br /> CITY OF [VERETT LOCAL SALES TAX CODE IS 9105 �D D O <br /> I ne�eby cwtdy(hat I have read��nd r,xnmined(hi;applicafion and knowlhe same to be Uue�nd <br /> correcL All provisions o/faws and o�dinances yoveminy lhis rype o/work�vdl be complefed -------- <br /> whe(her specdied herein or nof. Ihe�ranling nla pr.mut docs not presume lo g�vc auflronty to p[RMITIJ j <br /> v�olafe or canr.el lhe provisions o/any utfror sfafe or local law regulaliny consln�clion or ll�e ; <br /> pcdommncc ol cons(n�c6on. Ihal l nm aidhon�c[!by Um owncr o7(his p�operiy to perlornt U�c E I 3Q7 -ODjn <br /> work lor wh�ch applicalwn is made and I comply wdlr fhe Slale Confroclocs Law 78.27 RCW�nd <br /> ..--- ._.._--- <br /> 296 200 WAG <br /> � � � - ---��Z �/✓_ <br /> Signalure Vaie <br /> � <br /> r+t v�u�n vso�u <br />