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� ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> I� 3200 CEDAR STREE7, EVERETT, WA 98201 <br /> � �I // <br /> � 425-257-88'10 - FAX 425-257-8857 -www.everettwa.org �- ( S ` 7Y <br /> � � I�G��/O j <br /> � <br /> ; �qao �.,��.� ck� F.,� �k-�- w � q � a� �� <br /> ! PROJECTADORESS <br /> pw�ner� � 1,1ai1 Address Gty Slalc2�p Phone <br /> Ii �_�F �— <br /> Tenan� 6".atlAddress City StatelZip Phone <br /> ' S��O� \ r�i;c_cs 5��3 Psc;1`L �V.r-�- � �; �- s.,V�°�`�6 '-1�`� C��-tiS 4�`s`6�1 <br /> [ledncal Contra[tor h1aJ Address CAy Slate2�p Phone <br /> i <br /> i.�L a\S�N `�1 b`-\�,.� �Sa-bOb <br /> State Ur.ense Number(required) Gty ol Everetl Cusiness L�cense Number(reQwred) <br /> r'c r (`2.✓��rn� _ �C� \-i`� `�S I <br /> �i Proposed Use of Dui�dmg Contract Price ot Werk <br /> �3� 6$e�`��3�� <br /> ��c,��S_�\c,ss �oc�4— <br /> Square Footage pf residential new construclion, remodel or add��lion) Contacl PeisonlConlact Numberf[mail <br /> Number of devices QI low voltagr) <br /> Description ol Work to 13e Done, _ �r J.r,�� ��J\ � � � ��� S �V����--��—' v— <br /> --r v � <br /> __� � 5 �"� f� �C' �C _�_.��\ �CV � `5� — <br /> � � <br /> ---� JJv-�(' t� ryr�. � t n s1\Cn� (�.�,�• -- <br /> -� — --. <br /> Fte <br /> CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 i� ! OS <br /> �Y <br /> I heiehy ceRity fhat I have read and eaamined Ihis application and kno�v U�e same to be Irve and _ <br /> coitecf it l!provrsioos o/laws and ortiinances goveming lhis type o/wo�h�vdl be completed <br /> whefhcrspealicd hemm or noL The granling ol a pemiif docs not pnrtsurnc lo give a�lho�ity fo PERMIT?1 <br /> violate or cancel Ihe provisions ol any other sfafe or local law�egulafing const�uclron or the r I �,^ �' � � .7 <br /> pedomiance o!corstn�ction. That I am authonzed by the oo-nerol(his propeity!o perfo�m fbe C U � <br /> �rork lor which applic,Vion is made anAl comply�vilh the Sfafe Confreclors Law 78.27 RCW and <br /> 296.200 WAC <br /> �`\�� � <br /> Si naNre Datc <br /> r,c���sene.nsroi� <br />