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ELE <br /> CTRICAL PERMIT APPLICATION I�, <br /> , CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, [VERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — www.everettwa org i <br /> ��I _� f/, �� <br /> d� > c'' '-� / O v -- S f S L�✓ I <br /> I PROJCCT ADDRFSS i <br /> � _�1_�ti i � �` Y'��' �-�'r �.s �l,� <br /> I Meil A dress Cily SlalelZip Phone <br /> Owner I <br /> Tenant Mad Addrees City StelelZip Phane . <br /> i ' / �' y' t-_��� r� � � <br /> ��A r r 1� ,�, <br /> I Elr.ctrica�Corlractor ailAddrees C�ry Stateilip Phona <br /> � Stale Licensa Number Contract Price o(Work �I <br /> 5 ��� I <br /> � f'roposed Use ol Building Contact Person (Plan Review) <br /> 'Z(Dl) �J ! <br /> Square Footage (II resid ntial new construclion, remodel or addition) � <br /> Nur.iber of devices QI low voltage) <br /> I)?scription of Work to Be Done� �/ �`f �� �� �"� 'S�' � T ���� �` MT. '� <br /> FEE <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 C,-���C� <br /> l <br /> � hcrehy cevfdy fhef 1 hnve read nnd eAarrrined tlris npplicofion and know Ihe snme fo be(n�e nnd _ <br /> , �.mecf M pmvisions ollnws and ardinnnces�oveming Ihis type oI�vodc �vtll be cornplefed — <br /> �vhefher speci6ed herein or noL rho grnnting ol a pemiif does not presume fo givo aufhority to PcRMiT# � <br /> :iolate or cnncel the provisions olnny ofher slnfe or locallnw re�ulnhng consfn�ction or tHe r I � O� _ O� <br /> pe�/ormonce o!consfniction ThAf I mm�ufhonzed by the ownerol fhic p,�perty fo padonn the C J <br /> aorH lor which applica(iun!s mede ond 1 comply wiflr fhe Slefn Conlractors Law 18 27 RCW and _ <br /> 79fi 200 WAC <br /> � _ `�>���-.+ .l_ � <br /> .� .� - � ' /.� <br /> SlgnaWre Dete � <br /> � <br />