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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMlT SERVICES <br /> 3200 C6DAR STRE[T, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org 5 �a� -� 4 <br /> � � t�a5--a57 <br /> /oa/3/� �'r� S� <br /> PROJECTADDRESS <br /> �ntd�'U,{.,p �OU/3�/��' `�/� Gf�� �iFJS=:�S�� <br /> Ovmer MailAddress Gly State2ip Phone <br /> Tenant �dailAddress Cuy StatelZip Phone <br /> .�.�t nr.K��-Y 3.�.5`l�a,c�� aZ��. KlA 95�3 3 a 3s7,�s <br /> ElectricalConlractor P.1ailAddress C�ty U Sta1e/Z�p Phone <br /> S� ,5 od.� <br /> Slale Licens�ber Coniract Price of Work <br /> c / <br /> J <br /> Proposed Use of Buiiding Conlact Person (Plan Review) <br /> Square Pootage (I(residenlial new conslruclion, remodel or addition) <br /> Numbcr of devices(If low voltage) <br /> Descnplion of Work to f3e Done: _�lAl�_�d �,�_[�.±,Guv�d���__lY.N11�_�V -- <br /> �' �- ('�� _ � --- --- <br /> rFF <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �`�u� <br /> 1 he«:by certify fhat I havc read and examined(his applir,afion and lmov�(he smne(o bc(rur. and _ _JV `` _ <br /> conect. All piavisians o(/a�•�s and ordinances governiny Ihis fype ol r�a�k�vill ve comple(ed - <br /> whclher speci/ied hcrcin ornot. The, yian(ing ol a pertnif dnes nof r�resum�:(n give aulhority�o PLRMf l N <br /> viola(e or canr.r,l the provisions ol any olher slafe orlocallaw re�ulaling conslruclion or thr. ^ I i I O � I �� <br /> pcAnimanr,e n/r.onslmction. Tha(I am aulhonzr.d by the owner o/fhis piopr,rfy fo pedomr/hc t ��f <br /> wortr/or which applicafion is maJe and I cornp/y wrfh fhe Sfalr, Conbaclor.t I_aw 18.27 RCW and _ <br /> 29G.200 W� <br /> .___ 5-���'r�------- _�����5�- �7-1�L- ---- <br /> Signalu <br />