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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SER'VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX a25-257-8857 - www everettwa org <br />�l�'� a��' h��l <br />PROJECTADDRESS <br />�'1�K�.75�f�(11I`�� �dllf�lu 1i3�7'� Qt�._!_`�.��— -- `--�•-Av11CJ��-�l�'C��Z% <br />Uwner Me�tAddress Gty Str�te2�p Phane <br />Tenant <br />Ma�l Addrese <br />City <br />Slatc�l�p <br />_�L'1��,11�-�Z G�NjL1Z'( • - <br />C.lectrical Contractor Mad �ddress Gty Stete�Lp <br />Slale License Number <br />Proposed Use of f3uildmg <br />Square Footage Qf resideNial new conslruction, remodel or adddion) <br />Numbei o1 devices (If low vollage) <br />Uescription ol Work to Be Done __.__ �'����(L,i pO�L � <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />Coniract Price of Work <br />ContaclPerson (Plan Review) <br />I hemby ce�hly fhaf I h�ve rend and exarruned Nus �pphcn6on and Nnow Ihe s�me fn b� lrue and <br />com�cf �II provisions o/ lows nnd ortLnances govemmg Ihrs (ype ol work wdl be cornplr.feA <br />whefher specified herem or nof !he gran6ng ol a pemrif does nnf prnsume lo yrve aufho.dty to <br />vrolafe o� cancel flie provisions ol eny ofhe� slafe oi lucel law rngulating consfn�cfion or Ihe <br />peAomiance o/ consfnn:fion. Thal I am eufhon�ed by Ihe owner u/fhis propeAy fr, pedonn fhe <br />worlc lor wirir.h applica6on is made and I comply wr(h fhc Sfalr. Conlracfors 1 aw 78 27 RGW and <br />796 00 WAC <br />- - � ����3 - <br />Signalure Dale <br />:F� `?nv]mr7 <br />Phone <br />Phone <br />., <br />'iI) /i� i� >fiI � � <br />PERMCf1J <br />E� i 3a(�- r 9 I <br />