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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, W.4 98201 <br />425•257•8810 - FAX 425•257-8857 — www everettwa org 7_ 1�?_�� <br />[��03-C7�� <br />� � ��Z�� S� � �_ <br />PROJECTADDRESS <br />-{//���n� ,t���' -� �aa /�� <br />pwncr h1a�' Atldress <br />lenanl <br />Ele trcal C� tn� <br />State License Numbcr (iequned) <br />Proposed Usc cl Gm'tl�ng <br />Ma�l Atldiess <br />Ma i Atldress <br />r �� _� ,l ,, C -l��- _ ���"��9� i <br />�'� _ � <br />d� Slale/Zip V ne <br />Gty <br />C�'y <br />Statf?�p <br />Stalc!T D <br />P�one <br />Pnone <br />(4 7�I Pq T2 S O �� <br />C�ty ol _ e�etl Busmess License Number (reqwred) <br />Conlract Price of Work <br />Square Footage (II res�dential new conslructiun, iemodel or add:uon) Conla�t Person�Contact NumbedEmail <br />Nuin6er ol devi�es (II low voltayc) <br />Descript�on ol Work Io �c Donc �t�i� Q ( ' ' _. _ __ _ — <br />�r �� <br />FEE— --- --- � <br />CITY OF EVFRETT LOCAL SALES TAX CODE IS 7705 �% l�' U � <br />�J <br />1 horeby ceridy (haf I havc m,�d and exannned fhis appl;cu6on anA know !hc same fo be fnie and __ .__ _____...—__ ___ <br />conrc! All pmwsions ol laws �rrd urdinanr,es gmrmmg this fypC ol wurk wdl he tcmpleted i— ----- -- <br />whePrer specrhed hr.min oi nof. Thc yrinGng o! a penmf docs nol pmsunre to grve auflionty lo ' FFRh1ITlt <br />viulafe o� cancN fhe prt�wsrons ol any o�her s(�+te oi local lr+w regu�ahng consbuc6nn or fhe ^ I� O� - O�/ � <br />peAonnence o/ consfn�r.hon Thnf I nrn eulhnnrrAby 7he rnvnrr ol flvs pruperty lo perinnn Ipe t 4" <br />wOAe lo� which ap Ircahon is made and 1 compty wdlr !he Sldte Con(r�cfors I aw 18 ^I HCW anJ -- ---_ _— _- - <br />296 200 W�C <br />— — — �''--�--+=— - <br />Siqna�we _ ---__' — Dalr <br />qF��srnaaac;ou <br />