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ELECTRICAL PERMIT APPLICATlON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT', WA 98201 <br /> 425-257-8610 - FAX425-257•8857 -www.everettwa.org <br /> / 2—lg—/?j <br /> C l�J ! Z �1.1�c <br /> /�U�o �iFi c /�jj� ��✓�-�T/ �I//f. <br /> PROJECT ADDRESS <br /> '7 +.��,r K:x /� <br /> Owne� MailAddress City StatMZ�p phone <br /> �lf�i�t �(vi,'rCt /�$�'lo Nilt if/G �P, ti/i4 e�1 �✓/�• <br /> Tenant h9ail AOdress Gty StatelZlp Phone <br /> � / � � �� � <br /> PN . i �)N�i�Iz.*� 71�,n��-/'li/-_��ll�� .S� � �iC- �.L` �f��PY , � �f'�• <br /> Electrical Co�traclor ldail ACAress :dy State2ip Ptone <br /> �15 ' �7-�i/7 <br /> I��/��ir/ e.% 9�7� % �'�/� `=- � <br /> Slate License Number Conlract Price of Work <br /> ��r�,.��o-�i�r <br /> Proposed Use of Building Conlact Perscn �Plan Revievi) ? <br /> Square Footage pt residenUal�iorr, remode�or addition) <br /> Number of devices(Il low vollage) <br /> Description of Work lo Be Done: f��� /7- � • �/f��///�/✓Kt /N�pl���rxt i,t S�/1r� — / _�.0 <br /> I / <br /> � QL" ��� �� �,��1�T �>/i i7L'� —C I!/ CS��Ni � ` f�/Y��.q'- . <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> �� Z� <br /> 1 hereby certily Ihal I have read anAexamined fhis application and know(he sarnc fo Ac In�e and ` <br /> conecL All piovisions ollaws and ortlinances goveming Ihis type ol rvork wi0 be compleled <br /> whelher specified herein ornoL The gianfing oI a permil does nof prosume fo c�ive autho�ty fo p[RMITiJ <br /> violafe or cancel(he pvvisions oI any other s1a�e or local law mgWafing consfnicfion or(he � I� � � — I �� <br /> peAomiance o/consfruction. Thaf 1 am aufhonzed bylhe o�vne�ol this propeAy fo peAonn the <br /> �vork lor which appGcation is made and I comply wdh the Sfafe Conlracfors Law 78.27 RCW and <br /> 296 200 WAC <br /> �,(i"�� ((�/f�� ��a 11��//�� <br /> Signa ur <br /> nev�sruaoau - -----.------- ---- <br /> i <br />