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o- - - <br /> � _ _ <br /> - - -- <br /> - -- - - <br /> ELE:C�R�CAL PERMIT APPLICATION <br /> ��ITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — v✓ww.everett��va.org <br /> % ��2� ������� � ����u'� I <br /> PROJECT ADDRESS <br /> — — — -- -- � <br /> Owrer �dadAddress C�ly SlalelLp Prone <br /> I <br /> II --�-- �dai Atldress � C�.ly StatelZ:o Phone . <br /> Tenanl <br /> / <br /> � �1��.����r� �� 96.����s � /�o�-� ���� <br /> � cl�clnc2lCoMractor tdalACd•ess Gty Sa1NL�p 7no�-�e ,. <br /> i <br /> � <br /> � oy3�s� �� <br /> �y , '- 9ol,�i - _ , <br /> ', Statc f icers� Number Irequir? � City o�erett Busir,ess L�cense Number!required) <br /> `�f',r— <br /> � [/�Q <br /> Proposed Use of Bwlding Convact �nce o".'.�o�.: <br /> r��l��0a�clz/�G��`f��� I, <br /> Square Foolage (If residenl�al new consiruction, remodel or adddion) CoMact PersoNContac! Numbe�lEmad . <br /> � <br /> �! Number of devices Qt low volia9e) I <br /> ��L7�1�'��� �Z�� CiL���✓ �� � ��� <br /> Description ot Work to Bc Done. _ .---- � — -- <br /> I �-- --------- �� -- <br /> � FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 j �� �� <br /> I 1 <br /> I hereby certily lhat I have read and exanuneU Uus aPp�icalron and kno�v fhe same to be frue and L_ --- _ <br /> r.or�er.t All provisions olla�vs and ardinances govmiing thi; type n/�voAc wdl be complefed I U <br /> r:hefher speciTed herenr or noL �he yranturg ol a pennd does not presume fo give aufhority to PFRMIl�, <br /> v+olafe or cance/fhe provisions ol any olher::(afe or local fa�v regula(ing construction or Ihe r � , r ��� �I <br /> pedonnance ol eonstruchon. That I am aufhonzed by the owner ol Ihis property fo perfonn fhe <br /> l <br /> . i:�ork lor�vhich applica(ion is made and I comply wrth the State Confracfo�s Law 18.27 RCW and <br /> ?96 200 WAC <br /> i '�� <br /> �j'��. �� -8" '/� <br /> Ii,� gnat e Date <br /> � �+e.,uoca.cscaia � <br />