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ELECT�CAL PERMIT APP�CATION <br /> CITY OF �VERETT PERMiT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> I <br /> �ya5 �.on�waU �,��rR� �� � <br /> � PROJECT ADORESS <br /> I <br /> i 1��1� �Lr� � ��������,,_ =�r�a� ��- ��,�o � �la�-3� � -35��,� <br /> Qwner Mail Address � C�ry State2ip Phone <br /> 1 � � l u � 4 p <br /> Tenant MadAddress C�ry Stale2ip Pnone <br /> �153 i <br /> ;�o���� ; �mLG�i-�iP,�.��.++� 3��t�,,� � -�i�P,,'�,�1' l�l� �lt�2of� ��-3a�-a�oT <br /> Ele tnWl CoMrad MadAddress C�ry Stateldp Phone <br /> �-�'�t/h ��� ��-�b S�'�-c13� �-1 <br /> Stale License Number(required) Clry ot Everett Business License Number(required) <br /> f;�l'hr��fl,t�t ,�I `+�-15D� � <br /> Proposed Use of Building Contract Price of Work <br /> ��.�,;���mr.v�4��3a�-a� �°� <br /> Square Footage Qf residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> Number ol devices Qf low�ullage) <br /> Descriplion of Work lo Be Done: I1�15"�7i1,{�+ .In� ����I���� 1 U1 l�v�,���ci�s r,�v,rL <br /> 1��5�1,�u1 ��,w VY1r�n�tNw P(tl�l� 5 �f'D�' ('{ti►��c�lo.s. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I � � • r D <br /> �� <br /> I hereby cert�ly lhaf I have read and examinod this applicafinn and kno�v fha same to be frue and <br /> conact All provisions ollaws and ordinances govemmg this type of worfc wdl be complefed <br /> wbefherspeci(ed horein ornoL The granfing o/a permit does not presume to give aufhonry fo PERM[T# <br /> violato or cancel lhe pmvisions o/any other sfafo or local lnw regulafing construcfion or fho � <br /> pedomiance o/consWcfion. Thaf I am au(honzed by Ihe owner ol this property fo peAom�fhe E '�I 2-00 5 <br /> work/or which applicafion is made nnd 1 comply wifh fhe State Confrecfors L aw 18.27 RCW and <br /> 296.200 WAC. <br /> � <br /> ignaWr a <br /> FEllSEO C395::iJ <br />