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� --- ---� -----� <br /> ELECTRICAL PEF�MfT APPLICATION <br /> CITY OF EVERET'T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br /> C1310--0�1� <br /> ia --03-�3 <br /> � i <br /> % �-� � l' X a rc c.v� �� . <br /> PROJECT ADDRESS <br /> �I I �� �c�.�� L7���t�� <br /> Owner tvlailAddress Cuy Slate2ip Phone <br /> Tenani MailAdtlress CHy Stale/Zip Phone <br /> Z UG� � <br /> � �s`i�`Y�4 i Zyz3 /G�s s��� �,��,�C�ZrJ GJ�- ��fzz3 5�3�� �' <br /> Electrical CoMraclor Ma�l Address � Cdy Slate/Zip Phone <br /> � <br /> S'Vv�i= � � vtn i �i S`-! i�� �0 00 <br /> Stale License Number Contract Price of Work <br /> Propcsed Use of Bwiding Conlact Person (Plan Revie�v) <br /> Square Foolage Q(residential new conslruction, remodel or add�tion) <br /> Number of devices Qf low vollage) <br /> Oescription of Work to Be Uone� �SJ�uv� v�c��� C'ki��!'t �u t'���\�--- ��Q <br /> ♦ <br /> �,,d�t� / n �n� r r -� ln z� � �' �� � ���, n o.v�� l� (�� � <br /> � <br /> FEE <br /> CITY OF EVERF7T LOCAL SALES TAX CODE IS 3105 �O ��. <br /> 1 hereby certily that I have read and examined lhis application and kno�v fhe same(o he frue and <br /> cor�ecl. A!I pravisions ollaws and ordmances goveming(his type o/wodc will be campleted <br /> �vhefher speci/ied herein o�noL The granhng o/a pennif does nof presume to give au(ho�ty(o PERMTT� <br /> violafe or cancel the provisions ol any ofher stale orlocal/aw iegula(ing conslruclion or the r I � ' <br /> pedonnance ol consfnic(ian. Thaf 1 am authorized by!he o�vner o/this property to perlomi fhe C O _ D l L�-- <br /> work/or which application is made and 1 comply wifh the Stale Con(racfors Laiv 18.27 RCW and I <br /> 296.200 WAC. . <br /> _ � J I � <br /> ignaNre � ate <br /> RF:r5E0 L20/17 <br />