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'l , <br /> . <br /> —� � -- -- <br /> ELECYRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - vn�nri everettwa org �Q�`r y <br /> C I y05—m Z— <br /> ��o_ c�,_, I�� S� <br /> PROJECT ADDRESS <br /> � � � 1`��1� ���'' �" �U�l�-P� �til� �c z�� <br /> Owner Matl Address City StaleZp Phone <br /> �2�1�1��.�1.�,�1�Gr� 1� ��/�' �,Ir� tr�fl 1� ��zo� <br /> enant Ma�l�dtlress City Slate�Lp Phone <br /> u-�r(f'Y�l�l.(�Nl CD 12L( 2� t�-� n l��i1f �c �8�3� _ <br /> ElectricalComractor Ma�l�tldress C�ry Staie/Zlp Pnone <br /> N�,I'�i'Y1�1 (',1 �1� �,p'�- `�/,0-� <br /> State License Numher CoMract Pnce o(Work <br /> rop�� � D r�.�t� ������ �� �G�3 . Dj�f31 <br /> e of Bwlding Contzct Person (Plan Review) <br /> �JI��_ <br /> Squar Foofage (I(residenUai new consfruc6on, remodel or adddien) <br /> ' I <br /> Number of devlces(It low voltage) <br /> Descnption of Work lo Oe Done ��V�1/lY // 1/�JI�� ��1/11__����� vt��_ . _ <br /> -�—�— <br /> FEE <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 91G5 �O O� <br /> 1 he�eby Cr.�bly fhaf 1 hnvo mnd and r.ranuned lhis apphcalmrr nnd know lhr, s,-�nir, to he frur, :uid _ . . _ _ _ <br /> correcL All provi;ions o/laws and ordinm�ccc govc�niny Ihis typC ol v�ork v,Jl bc cornpin,lr.d — �-- <br /> whelhr,i sper,ificd herein or nnf Thc granling o/a prrrnrt dor,s nol prasunre(o givr, aulhonty!n PERMCftt <br /> violafe or canr.el Ihn.provision.;ol any ofher stafr, or lor.al la�v regul�hng r,onSfn�r.Gon nr(he t f <br /> peAnmiance o/r,onsbur.tior, Thaf I am aulhonzed by fhr, owncrnllhis prnpr.rty lo pr,rlorm fhe E � l.-1 O�._ �O Z <br /> wo�k Ior whrch applicalion is rnade and I comply wdh fhr. Sfa(e ConVaclors I.aw 18 27 RCW and � � <br /> 296 200 AC <br /> ������_ ' �X Nl.��ly <br /> Signa0.uc Uale <br /> nt wvG.trian <br /> 2i-/ �1- 0� 2i <br />