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Y <br /> � I� <br /> ! <br /> - -- ry{ <br /> ELECTRICAL PERMIT APPLIGATION ` <br /> �. <br /> CITY OF EVERETT PERMIT SERVICES �:=; <br /> 3200 CEDAR STREET, EVERETT, WA 98201 S � a —I 3 <br /> 425-257-8810 - FAX 475-257-8857 —www.everettwa.org C(3 0 S'�„ ,l <br /> d-ci <br /> /Sz0 �/ s� ST <br /> PROJECT ADDRESS <br /> �te 2ST- 1/-e. �•` ! o�ru.�.vT 5�0/Y Co I 6N ��� �In� ��/Ze�7T wR' 90 Za I <br /> Owner M11ail Address dy SlatelZip Phone <br /> �✓Aes <br /> Tenanl Mail AJdress City State/Zip Phone <br /> ���. ,r-r�e �-�z,� 23��y 3o�,4dES- ,Ctw�- W6� ���13Z 106 �7� 7_86� <br /> Eleclrical on�ractor Mail Address City Statel7ip Phone <br /> ����r 3G � d�� - — �i-�o�. a� <br /> Slate License Number Conlract Price of Work <br /> �,.e._s�ffi.c R�ft/N ,j G�fr,z IS O�fG t-(�S <br /> f Contact Person (Plan Review) <br /> Proposed Use of Building <br /> Squere Footage (If residential new consiruclion, remodel or addilion) <br /> Nuinber of devices (Ii low vollage) <br /> Descriplion of Work lo Be Done: �l�' / ,��� �����" �� � � /` �� I <br /> �`l�¢r.G.S✓ �y�}"�✓ � <br /> I <br /> i I <br /> FEE <br /> -��J 5C� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 J I <br /> 1 hereby certify that 1 have read and examined(his applicalion anc know the same fo be We and <br /> conecf. All prnvisirns of laws and ordinances goveming this type o/woifc will be completed <br /> whethcr speci�ed herein or nof. The granfing o(a pemiit does no(presume!o give authonty to PERMIT# <br /> violate orcancel the provisions of an ofhers(ate orlocal law re9idating censtruction orthe � ���� �^ � <br /> perfonnance ol const!uction. Th em authonzed by the owner ol this propeRy to perform lhe "7 — ���-' <br /> wo,dc(or which application i ade and 1 comply with the State Contractors Law 1 b.27 RCW and � <br /> 296.200 WAC. � <br /> ��� ' -- �z- i� <br /> I Sig�ature Dale <br />.- ,•. r.=vise��;za�i� � <br /> . — - ' _..�__...,. _.. ti �:... �. <br /> � r ..�w..:.- � �----- `"- <br />