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Oct 28 15 12:15p p,2 <br /> � <br /> ELECTRICAL PERMIT APPLtCATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STRE�', EVERETT, WA g82p1 <br /> 425-257-8814 - FAX 425-257-88�7—wnn�w.everettwa.gov <br /> � I 2 fa �L�.�Y�� ,�1-1�� <br /> PROJECT ADDRESS . <br /> �Z 5 <br /> �1�.a� ���1 � � � n� �� �l� ��� 32� <br /> Ow�er Mail Address City State/Zip Phone <br /> TeRant . Mail Address City �1, State2ip Phone <br /> / <br /> �1�� ��l'D 5 ID3� � c�� ��ns ���25� ��y- <br /> ElEctrical Contractor Mal Address City State2ip p � <br /> �R����S� 1 t���0 .. �z�! � <br /> State License Number(required) City of Everett Business License Nurnber�required) <br /> ��� <br /> Proposed Use of Building Contract Priee of Work <br /> a"��D c�e1 rr�� `�c� 1 nC' C <br /> Square �aotage (If residential new constniction, remodel or addition) Contact PersonlContact Number/Email <br /> Number oF devices(If low voltage) <br /> Description of LVork to Be�one: � � � � <br /> FEE <br /> CITY OF EVERETT�OCAL Slk1,FS TAX CQD�IS 3�U3 ��/ �� <br /> �v' � <br /> l he�eby certify tFrat I have read and examined tfiis application arrd Ivro�v the same Eo be true and <br /> correct Afl provisrons ofl�ws and ordinances govemfng fhis type ofworfc will be complefed <br /> u+rhether specified herein or rtoE. The granting ofa permit does nof presume to give authority to pERM1T# <br /> violafe o�cance!the provisions ot any othersCate o�local law regulatrng consfrucfion or the / <br /> performarzce af consiructfon. That!am aufhonzed by the owner of this property to perform the E � "J� U '��,� <br /> v�orti for w,hich applicatro � a e I comply wrth ihe State Contractors Law 98.27 RCW and <br /> 296_200 VllAC. <br /> S re D e <br /> rzEws�o oaoF2c;a <br />