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. ___. _ ___ _. . _ _ _.. ___ _ . . __ _ � . _ _____. _ _.. _ . _ _._—_ __. _ _ _ . _ . .i <br /> I <br /> ELECTRICAL PERMIT APPLICATION <br /> , CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX d25-257-8857 —www everettwa org <br /> � <br /> I <br /> ,l ,�o � lo o sr s �-✓ <br /> PROJECT ADDRESS <br /> _� (aC'_G�i=---'�'—/J7 t r r i,s�4S <br /> Owner M �I Address CAy Stata2ip Phone � <br /> Tenanl MaA Address Clty SlalelLp Phone I <br /> i1�v Y `i t �r� !� �� /� !, ,L��l l. �r� <br /> _---_--___.... . --�J . _ _ . . .. - ---- <br /> EleclncalContractor dadAdtlress G;y StaleN�v Phone <br /> i <br /> i <br /> Stale License Number CoMrad Price ol Work I <br /> �i ` I <br /> Proposed Use of Huilding Contacl Person (Plan Review) <br /> Square Foolage (If resldential new construclion, remodel or addelon) <br /> Number of devlces (II low vollage) <br /> Description ol Work to Ele Done. L✓/ �"� � � � � s � /� T /V L' L`/ /�fo �� �_ <br /> —�--- -- - <br /> FEF. _n <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 8105 (/11 �W <br /> I hereby cedrly Ihef I have read and exemined Ihis application end know Ihe same fo be fnie and `_.___.____.___ _ _._ <br /> wrrecf All prtwisions ol laws anA o�d�nances goveming Ihis type ol work will De conrple(ed - ------------ - - --- <br /> whefher spedficd harein or no( Tho granling ol a pFmrd does nof pmsume fo give aidhonty fo PERMITk <br /> violafe or cance!fhr. pravrsions ol any ofher sfafe or local law reguldfing construcfion or fhe <br /> pedomiance ol r.onsfnicfion Thaf I am aufhonzed by fhe owner o/tlus p�operty fo perlorm fhe E I 3� 5 -- � l 3 <br /> work lor w6ich appllcafion is made and I compty wdh the Stafe Con�iac(ors Law 18 27 RCW antl ___ __ <br /> 796 200 W�C <br /> --���� .s-'- � o -��- <br /> - -- - ---- <br /> Signalure Date <br /> v,c v�sco ira�u <br />