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ELECTRIC�►L F'ERMIT APPLICATICIN <br />CITY OF EVERETT i'ERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 a 41q _ �l� <br />4'15-257-8810 - FAX 425-257-8857 - www.everettwa.org G��o a�C <br />� Lo�l� �3ox ��lP � z°S�'� <br />2 �i I� � � �- S'� � <br />PROJECT ADDRESS f� C�� U h /, ��I 7�ODZ <br />���C� RO ('�n S /�� ,/ // <br />�/%� i��l�J"Urh 1�/�� ✓" trLl LCr�9 �I/���o6-Z3S-4S5/ <br />Ov+ner <br />Mail Atldress <br />Tenanl Mail Address <br />C� C vt.P �'�ec�r,'c 6Z�f3 ��C�`i� � <br />Electrical Contractor Ma�l Address <br />Cp�ANC-� � �6'S/�K <br />State License Number <br />Proposed Use of Building <br />Square Fool2ge (I( residenlial nevi conslruction, remodel o� addilion) <br />Number of devices Qf low vollaye) <br />�,e�J 20U t� <br />Descnplion o( Work lo Be Done. <br />City <br />Gry <br />Cily <br />S�BIE/Zip ruuii� <br />� Stale2ip Phone <br />�'� � ;�,�/� ���t 9cY�iz� <br />Stalei7ip Phone <br />.�2�'� � <br />Contract Price ot Work <br />Conlact Person (Plan Revrevd) <br />Se�vi1G(' /��Pf'/�iscF�izvc� <br />CF)n� b ° <br />F[C- -._ . _ _ — <br />CITY OF EVERETT LOCr1L SAIES TAX CODE IS 3105 �� O� <br />I herehy cc�(ily fhat 1 have reaU and exarnined fhis applir.afion and know fhc �arne (o be frur, and -__ .� ----- --�------ � <br />correcL Flll prnvisions oI Liws r�nd ordinances goveming fhis type ol work will be cornpleleU <br />whefhr,r specihed herein or nof. The gr�infin9 0l a pemiit does nol presumc fo give uuthonty (o PERMITB <br />vinlale or cancel the p�ovisions of any olhe� sfafe orlocal law r� yulalin9 consfrucfion or fhe r �. r O�_ � D� <br />mAorrnanr.e o( constmr,t� f�l Thal I arn aidhonzr,cl by the owner u( lltis p�operty (o pedonn (he <br />C �.�. <br />woiic (or �•+Lic6 apphcaf � Is made and 1 comply wdh fhe Sfafe ConVac(ors Law 78.27 RCW and _. _ -- <br />296. 200 WAC. � <br />� <br />�z��� 2�� �/ <br />„��,�<<> „��„� <br />