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• &Q/4e2 ' '',:91-- -.?6"-..37- <br /> . <br /> /D _05� <br /> . �a35.o7 <br /> • ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES' . <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> • <br /> • • - <br /> PROJECT ADDRESS / <br /> • <br /> 7/t/4. A&,ix 3747 Lla/Y6f za9 4812 /-,17„.7.07 - .25.-.302---, /,2 <br /> Owner Mail Address <br /> City State/TP Phone <br /> • <br /> Tenant Mail Address City• state t <br /> x2s z91,z`one <br /> • <br /> Zildwasag2ze h .II. . Z. _/�'. l'1 x;.2.75 f/25-294-69514/ /���// <br /> Electrical Contractor Mail Address City State/Zip Pho <br /> �'. ��,ecc.,92 a Z. _ X01/ 92v .� <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan 1Mevlew) . <br /> Square Footage(If residential new construction, remodel or addition) <br /> • <br /> Number of devices(If low voltage) • • <br /> I <br /> • <br /> Description of Work to Be Done: . ' _ _/ _ -4. !_/ - _e,, / / ,._//, <br /> /_!/' J ,Jg O/ �/ • , <br /> • <br /> ----th712&71Ar:d4/222e.gia, . <br /> • <br /> FEE . <br /> CITY OP EVERETT LOCAL SALES TAX CODE IS 3105 ‘f_533- <br /> 105 _53 ?. <br /> I hereby certify that!have read and examined this application and know the same to be true and c J <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provision of any other state or local law regulating construction or the <br /> performance of construction. That lam authorized by the owner of this property to perforin the E (30 - (A <br /> work for which.application is made and 1 comply with the State Contractors I <br /> P rsLaw18.27 <br /> 296.200 WAC. RCW and <br /> /� Imo//—A'% 1 "o I - <br /> 'nature Date - <br /> • <br /> REWSED 3/20/13 <br /> 1 <br /> 9/£:a6Ed L988L9Z5ZT76:oZ :111013 Li7:90 ETU-TZ-011V <br />