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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881U - FAX425-257-8657 —www•everettv�a.org <br /> 7� /�V� Sc� '7 �.� —1 S <br /> � IS a7-�3�1 <br /> �� �2 � ���4�,���' <br /> PROJECT ADDRESS <br /> � ev� .1� vas�� IZ3as )�i� ��� .5�� �� �� � � _ <br /> ��ry Stale2ip Phore <br /> Owner Mail Address <br /> Tenanl Mail Address <br /> City State/Zip Phone <br /> ;q �,Q��ic I 1n1� lfl G I?/�' P G+l c���cl�c,�eQ �9 yu� ?�^� l9� <br /> ElectricalConirador MailAddress <br /> City State2ip Phone <br /> ,.1 � a �ied � 7 g �� <br /> q,n°n 'p� Q 06 -- <br /> tT L' City of veretl Business! icense Number(required) <br /> S�ate License Number(reqwred) <br /> 5�' \ —'—'-- Conlract Price of Work <br /> Proposed Use of Buiiding <br /> __---- � <br /> Square Foolage(If residenlial nrw conslruction, remodel or addition) <br /> Conlact PersonlContact NumbedEunail <br /> Number of devices(If low voltage) ��� <br /> Description oi Work to Be Done: �� <br /> �4,��,�J , — — — <br /> �---- ��- <br /> FEE � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �� � I <br /> 1 heieby ce�li(y fhaf I have read ond n.xarnined 7his applicafion and knov+fbe same fo b�true and <br /> conecL All piovisions ol laws and ordinances govr,rning fhis type o/work will be completed <br /> whefher speci(ed hcrcin or nof. The granling of a nemiif does nof presume fo give aufhonty fo PERMIT# <br /> viola(e or cancel the provisim�s of any ofher slate urlocal lavi regulating consf�ur.lion or fhe E I 507 � U3� <br /> perloimance o/consfrucfinn. ihat 1 am aufhr,nzed by lhe owner o/fhis property to pedonn!be <br /> work lor which app6c ' is m d 1 comp/y wdh Ihe Stafe Confrar.fors Law 18.27 RCW and <br /> ?.96.?.00WAG �� � � /� <br /> Dale <br /> Si9naW <br /> reviseoaenuaori ----- -- --- ----- - �--- <br />