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� - - � <br /> ' ELECTRICAL P�RMIT APPLICATION <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> ' 3200 CEDAR STR[ET, EVERETT, WA 98201 <br /> ' 425-257-8810 - FAX 425-257-8857 – ww�.• everethva org <br /> I <br /> i � $�� 1C�CG��`�n <br /> PROJECT ADDRESS <br /> ��:�T rQ�L�a� f s;�,F ��rau�:s ?B�9 �Q�u��� c����� �a zs.�o� <br /> � Oerner 7Aaindtlress Gry SIa1e1Z�o Prone , <br /> � � SAME <br /> ��enaN � R1al Atldress GIy State2�p Phcne ' <br /> ,n 3�0 - <br /> '. //-� 1-11 �.LF..CIeiC__ 4t7�1_ /�lc(�cc«.ti� j��r_ �v�<�ac;� �/i'1- °I-f.?0I �G/-OS(� <br /> [Icttacal ConVacior 1�a�i Acd•ess C�ry 5'ate�Z�� Phcne <br /> /� � /,/l o� <br /> /. J�AI�ILL�= � 9 �4 �l� � L�v ' ��f— <br /> State License Number Contract Pnce o(Work <br /> LJ�I,J �7�✓6N i I <br /> Proposed Use of iiwldmg Conlacl Person (Plan Rev�ew) <br /> Square Footage �If residential nea conslruction,remodel or addiLon) I <br /> ' Number of devices Qf low voltaye) I� <br /> Oescnphon of Work to�c Done _ I��S� PiJ�U L•.T (�[ r,/ _ /�.V(.� /�.�[JN,(�L C! Nl-'�/ � <br /> _L(� __ �-Ii4N�Ol���_f�lA(Q ��ovr= _ T��° r:�,v„ I <br /> - ------- ----- - - --- - -- <br /> � -- - - - ------- _ I <br /> - _ -- ----- - - I <br /> ,� I�I E[ - ---- - ------ --1 'I <br /> � CITY OF EVERETT I.00AL SALES TAX CODE IS J105 i ��,SO il <br /> , I hereby cerU(y th.�f 1 have rr.ad and exartuned(h�s app6caLon and 6nu�v fhe s.+me lo be tn�e�vid ------- ---____-- <br /> �� correcf AO provisions olla�vs and ordmances goveminglhis fype ol work�vill be cornple(ed -- ------- - <br /> ' �vbe�her specdied hemin ornot 7he granfrng o/a pernuf does not presurna fo givc aufhonty to � PERI•1IT' <br /> � crolale orcancel(he procisions o/any ofher sfate or local lav:reyula6ng wnsh»chon or(he � I ^` ^_ I�1 I , <br /> perfonnance oI consln�chon Thal I am authonzed by the av,ner ol this propeRy(o pe�lonn the �J V I <br /> ! v:ark/orr;h�ch appl�cation�s m�de and I comply�t�dh Oie Sfafe Con(rac(ors La�v 18.27 RCW and �--- - . -- ---_. __ I , <br /> �, 29G 200 WAC. .'// ,� , <br /> /// I <br /> � ! ,� ��--�_ � � �S - � 3 <br /> �� S�gnat �c D2Ie � <br /> I <br />