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i <br /> i <br /> � <br /> • I <br /> ELECTRICAL PERMIT APPLICATION ! <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 i <br /> 425-257-8810 - FAX 425-257-8857-vwvw.everettwa.org <br /> I�`-d'a—�`� � <br /> ; <br /> �`�f � �--o� � i ; <br /> � DUI�- �� dhc, SE �I <br /> PROJECT AD�RESS <br /> �-I av+sP-� L-o�r loo (a ��.,�c sE ��.� � 9tc��R , <br /> Owner MallAddress City State2ip Phone ' <br /> I <br /> i <br /> � <br /> i <br /> Tenant Mail AAdress City StaierZip Pnone I <br /> �&S l-�c�t'�� �No°I- ���.zre�-1- kve. F_ve.iz.ti� i,c.� �4'szo t 4z�-�s�.-�ry j <br /> Eledncal Contraclot Mail Address Ciry SlatelZip P�one � <br /> Gsr�rt-�sts�aa-� v 19�8 s— ; <br /> Stata License Number�required) City of Everefl Businoss License Number(required) � <br /> � 9$q � oo <br /> Proposetl Usa of Building CoMract Price ol Work <br /> 13oU Dawn �rvx� u2�• zrz- u`��. <br /> Square Footage Qt residenlial new construction,remotlel or addition) Contacl Person/Contad NumbedEmail i <br /> i <br /> � <br /> Number of devices(If low voltage) <br /> Descnption o(Work to Be Done� � Yl >�w✓. ��(*IQSS 1�2��I.ULIY� �� <br /> . . . . . ... . . _ _ . . . __ _ . _. . . . _. ... _ _- - -- - - - - -- - . . _. ..- - - - - . . .. _. _: <br /> _ _--- .... . _ ..___. _. .. . <br /> � <br /> FEE ; <br /> 1 <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 9105 �j�(�(� <br /> I hereby cortily that I have iead anrl oxamined this opplicalion and know Iho sarno to 6o fruo and V � <br /> conecf. All prov�sions ollaws end ordinances govaming this lypo oI work viill be completod � <br /> i <br /> whethor spociliod herein or noL Tho granfiny o/a pormif does not pmsumo fo give aulhonty ro PERMIT� � <br /> violato or cancol lho piovisions o/any o(bor stafo o�locallavi�ogulating construclion or tho � I ' r f � ' O�� I <br /> performance o/consfruclion. Thol l am outhonzod by Ihe ownor ol ihis propoRy fo peAorm fho 4'I <br /> wak Ior which application is made and I comply wi�h fhe State Confraclors Law 1827 RCW ond i <br /> 296.200 WAC. I <br /> � <br /> � �I J 24 I I l� I <br /> Slpnaluro Date i <br /> i <br /> FE�ISE00896?OI1 <br />