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- -�— � - <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE7, EVERE'fT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — www everettwa org <br /> ,J � /3�s ta�e <br /> ��'10 O /OwQy S Y�/�c(� ( J iNcQP�.,,{C (�h rey ��., � <br /> PROJECT ADDRESS <br /> I <br /> ��� ��.Mu.,.�y �o�l,SZ z�J Towz� J�-��,F- E�u-� w�-q�L�r <br /> Owner MaitAtldress CAy SIatNLp Phone <br /> Tenant fdail Atldress Cny State/Lp Pnone <br /> 2�-276-6Gz9 <br /> �Ie�Vre� �Sevv� c.c� E S�c�r..�� �z�. ZSbP S . 2� zh� r� ,��.�` Z•I� Q�a32. <br /> EI2CIriCal COnirac�or Mail Atldiess Cdy Slate/Lp Phone <br /> E �cc� ss �3l 2<-2 2.Sb <br /> Slate License Number Contract Pnce ol Work <br /> Ev�re�E' Gb,Mn.u�z;l,3 Ca/(ee¢ <br /> Pioposed Use ol Buildmg ' Conlacl Person (Plan Reviee�) <br /> �Oo.� S� Fr' <br /> Square Fooiage QI residentlal new conslruction, remodel or addiuon) <br /> �� <br /> Number ol devices pl low vollage) <br /> Descriplion of V�brk to Be Done. .��tfr..G(� t,eGl�s�� S Stc�r. _ <br /> �EE <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 I G, O _ �� <br /> ✓ <br /> I he2Gy certdy fha(I have read and^xarnined this application and know(he same lo be tnie and <br /> co�rect. All provisians ol laws and ordinances goveming fhis fype o/work will be compleled <br /> whefher speci�ed herem or noL The granfing o!a pemnt does no1 presume fo give aulhonty to PERMITII <br /> violate or cancel the provisions o/any ather slate orlocal law m9ulafrng consWcfion or fhe r ' <br /> perlom�ance ol construc(ion Thaf I am aulhom.ed by the owner ol�h�s property to pedo�m Ihe C � 5 o S— ! O L� <br /> u•orN Por which applicafion is nrade and I cornply wdh the S(a(e Con(racfors Law 78.27 RCW and � � <br /> 296.200 Ih�AC. <br /> �=/�'��13 <br /> Slgnalure Date <br /> FEV�SEO 3RLi�3 <br />