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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa org 6_a6-i� <br /> (_, I�Ob-Jb� <br /> �ho-� P�; �;�, A�e. . _ <br /> PROJECT ADDP.ESS <br /> OwnM M11a�l AEdress Gly Statc2ip Phonc <br /> ��,�, C�. Lve�re�F A `lA^_O� - - 4 b <br /> Tenant Ma��l Address C�ty :IatrJZip Phone <br /> All�e� t=��' �.ri,.r.\ �oi�� „� u.;A � � - 4 - <br /> EICCInWICOnirOClor Ma�lAddre55 CAy SIaldZip Phonc <br /> AL� i. ESv 2'��RP� � '?�A�5. 52 <br /> 5tate L�cense Number Conuacl Pnce of Wo�k <br /> Proposed Use ol Building CQntacl Person (Plan Revicw) <br /> Square Footage(If r¢siCenlial new construcUon,remodel or addltion) <br /> � <br /> Number ol devices(II low vollage) <br /> DescnplionofWorkloBeDone�. 1.-0..� Jcrl4�et¢. �f��%�tR ���c'C- aa3K�_�.�'�'�`�� <br /> 1 <br /> FEE <br /> CITV OF EVERFTT LOCAL SALES TAl(CODE�5 J105 rI O � <br /> I hereAy certity Iha�I have read and eramined fl�is applrcafion and know fhe same lo be true and l` � <br /> r,ormd. All pivvalons o/laws and ortlinancr.s goveming fhls type o�woM wdl be complefed <br /> whether spcnfie0 hemm or noL The gnnhng ol a permil dces nof pmsume fo give aufhonry to PERMIT# <br /> violale or cancel the provuions o/any ofher slafe o�Iceal law regulating consfmcfion or Ihe � <br /> peAormance o/consfmcfion. Thaf 1 am aulhonzed by fbe owner o/fhis piopeRy fo peAorm fhe ��o�- �6 q <br /> wo�k(or which application i and I compry wifb fhe Stale Conlractors Law 18.27 RCW and <br /> 296 200 WAC. "i\'� <br /> � � zs �y <br /> n <br /> ignatum ate <br /> urv�sra iaai.+ <br />