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_ _ _ i <br /> � <br /> ELECTRICAL PERMIT APpLICATION <br /> CITY OF EVERETT PERMIT SERVICES �� ��3 <br /> 3200 CEDAR STREET, EVERETT, WA 38201 6 " rG� <br /> 425-257-8810 - FAX 425-257-8d57 - www.everettwa.org G�-3 p6 -b a l I <br /> I � '� 1 //� r�' , i �c" <br /> � PROJECTADDRESS <br /> I <br /> 7 - ����-!, .' � -- <br /> Owner MaJ Atldress City SlatelZ�p Phone I <br /> � 1 - rhC-��1 � �' _ � <br /> Tenant Ma�1 Address Ciry SlateiZip Phoo= <br /> �ras� .�s.�-�asa <br /> � W '�N ��;N�i, I� ID c`'f�C`� 6'1-Stc� � ✓� 2�TT i.<-'PE �J�v?C� <br /> Elecuical Coniractor MaA Address City State2ip Phone <br /> i vV K C �l/G G I 90� t7k �l,Cr�. c��, <br /> I State License Number Contract Price of Work <br /> II _ I <br /> � Proposed Use of Dullding Contact Person (Plan Review) <br /> il /S� �r' �"'T. <br /> Square Foolage Qf residential new construction, remodel or addition) <br /> Number of devices(�f low voltage) <br /> � Description ol Woik lo�e Done: /7 n,�� �� � `e'u-> U���-�Q�~G � � �.l�TS �O/C� <br />- �"CLF - 'IC�rL�,�fv�/�c�i �,ON ��1�� a I <br /> I � <br /> I <br /> I <br /> FEE � <br /> �:) <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 SD <br /> i hemby cer6ly thal I have rend�nd eamrrined this applicahon and kno�v the sarne to be hue nnd <br /> cormcL All piovisions olla�vs anJ ordinui,ces governiny fhis type ol�voik u�ill bo completed <br /> ��hcfhcr speciGed hcmin or noL The yr�nfing ol a pemiif does not presunte to give autho�ty to PERMITti I <br /> violafe ar cnncel Iho provisior�s ol nny ofher slefe or local Imv re idatin consfrucfion orlho r, r <br /> peAonnanca oI cons(n�clion. TDnf I am nufhonmd Gy the own[rgo/thi pmpe�ty fo perfonn the E I ��v�p � Q�� <br /> wo�k/or which applicnfion is rnnde anJ 1 comply�vith(he S(n(e Contrac(ors Low �8.27 RCW and <br /> 296 200 WAC. <br /> ) <br /> � ' i <br /> l �_ '� �G� �(�. � (l- - / l — ��'' <br /> / S�gnatuic--- - �- ------- Oace <br />