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— - - —� <br />ELECTRICAL PERMIT �,PPLICATlOfV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www everettwa org <br />IZC�oS �8� ��. 3._' _ <br />PROJECT ADDRESS <br />J1�_S.t��t-c_ C� o.� � T�'�cT � o.,. O�" � �� <br />Owner ldad qadress Gry Steterziv Phone <br />Tenant <br />Electncal Contrador <br />f,�Jui C-e L 93G K I <br />Slate License Number <br />Mad Ademss <br />r�,�i naam�s <br />� <br />Nc.a /faMc C'��`T^-�4i � o� <br />roposed Use of Butldmy <br />ZS �S <br />Squam Footage (If resident�al new conslruction, remodel or addrtlon) <br />Number of dewces (If low voflage) <br />DescnpUon of Work to Be Done� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />Ciry <br />O� F� � <br />c�ry <br />StatelLip <br />State2ip <br />� <br />ySoa. = <br />Contract Pncc of Work <br />Contad Person (Plan Review) <br />I hcreby r.crtiJy fhaf I have ruuA onA exnmined fh�s applrcnhon and know thc snme !o bc fn�e and <br />co�recl All provisions o/ laws and ordmances govorning fhrs typo o! work will be complefed <br />wholher spcafiod hore�n or not. Tho granhng o/ a pormrf doos not prosumo to grve oufhonty fo <br />vidafe or cance/ fho provisions ol any otho; sfafe or lowl law rvgulehng constructmn or fhe <br />podormnnce o/ constroctinn. That 1 nm aulhonzod by fho ownor ol lhis prnperty fa pedorm fho <br />woAc lor whicA apphcafion rs made and I comply wdh fhe Slafo Contracfors Law 78 27 RCW and <br />296 200 WAC. <br />REVrSEDY.'6�I1 <br />P�onr. <br />P�one <br />FEE <br />�b�OU <br />P[RMIT# <br />E ' c�p(� _��-�, <br />1 <br />