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ELECTRICAL P�ERMIT APPL�CATtON
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> � "' � 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8810 � FAX 425-257-8657 ((E)everetteps@everettwa.gov� www,everettwa.gov/permits
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<br /> PROJECT ADDRESS: ,�Iz� ' .'�'° '. • . 'C� , _
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<br /> ��JI1�1NG AREA�residential,new constructlon,remadel,or addliiptt
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<br /> �UtLa1NG TYPER ; % ��3ETACHED O SFR-ATf'ACHEQ �DUPLEX ❑MULTI-FAM{LY-#OF UNJTS; ❑COMMERCIAL
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<br /> OWNER NAME: °' ;�' � _
<br /> OWNER MAIUNG AD.DRESS� ` TENANT��A�ltE: Coht�arcl�t:
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<br /> l�M�kftY CONTACT: ❑OW� , -� �� �� - � -- �
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<br /> ���+��'�t�ANiE: „ ' ��N`�ACT PHONE:
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<br /> AGREEMENT.T!heroby certify fhet ;heve read and exemined this appliceflon and knowlhe same fo be lrue end 6onecL Al!proNalona otiawa and ordfiances goveming ihfs type
<br /> oI wo�k w!!t be compieled whefhar spectffed heretn or not. The granOng o/a permlt does not presume fo g/ve author�ty fo vlo/afe or cence!fha provlslans of any ather sfafe or
<br /> local/aw reguleHng conshucNon or fhe perlomiance of conshucllon. Thaf I am euthorized by the ownerof thls property fo peHotm!he wwk!or whfch appi/caflon is made and 1
<br /> complyWlfh the Stafe Conhactors Law 1&.27 RCW and 296.?00 WAC,
<br /> CIly o/Everett OHklel Use Only
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<br /> PERMIT#
<br /> �.--�.:�_:..y.��'�'�.�' ��a���� .�° E ��3 -- ��"j
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<br /> ��'���u� rE�e�Agent;�e�gnature
<br /> ^�. Date .
<br /> (Revlsed 9/23/2019j
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