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-- ----- ___�.._���� .� � � .w��___._.. ��� �_..�._.�:.V_, .���______--�.-�_---- - <br />� � �� EL�ECiRI�AL P�RM�T APPLICAT��(�N � � � <br />CITY OF EVERETT` PERMIT SERVICES : <br />3200 CEC7AR STREE'C, �VERETi", WA 9820'I ` <br />426-267-881 � - FAX 425-257-8857 — www. �verettwa.org <br />� ,� � 7 L i r�Q� �-�` ��� �.� . v�/� � 20 / <br />PROJECTADDRESS <br />.l��. ..G+.t.�....�..��:.�.,L�..J�t�1 !+'i�if'f��L ! ..L_.,—...�._..__._... <br />Owner Maq Address Cky 3iate/Z1p Phone <br />Tenant MaliAddresa Clty Stete� Phone <br />c�z5- 7�-8t�q <br />�-�� ��!�.�.�n�1� �� 2z�D� 5�" �� �yr�� �:�o� � ��- �83�� <br />Electtical Gont�ctor MaI� Addrsss City StatefLip Phnne <br />,�GTIV�'�d�'i�C�� C12� 2-�f '�' <br />State I.icensa Number {req Cred) City of Everetf �t�ainess Llca;nse tJumber (requiredj <br />l�p� �.."t � �',t��"fi` '�� Q1S�.t... � 3'�:� . f�C� .� <br />Propased Use of BuUding Contract Prlce of Wor}c . <br />N�j'N4A1� fJl3�t l.l 't'+Z 5' Z 18' �_ �%(�-} <br />Square Foatege (if�residential new consM-'I'oqon, remodei or additfon) Contact Person(Contact NumberlEmaii� <br />�( n <br />Number o�devices (lf lovi Voltage) <br />'I Dascriptian of Work to Be Do�e: ,�� �V� ,����Pt 1��,�� �.�( I�� �"'"�` 1��_.C�� �—��x.L.,:. <br />I <br />� � <br />FEE �' V.__.. <br />CfTY OF EVERETT LOCAL. SALES TAX GODE IS 3'105 � tl.� QO <br />�. <br />f h�re6ycertify that l have read pnd examined this apptleation and know the same to be irtre^and � <br />corrBct A!! p�rrvistons af taws and arcflnances gaveming this ty�e of work ►vlll 6e complefed -- —�-� - <br />whether spscl�ed her�fn ornot. ihe grantlny of a permtt aaes notprasume fo gtve aufhorify fo PEftMIT# # <br />vlolate orcancel ths prnvlsions of any ofher state arloca( !aW reguta�ng construcdon or fhe <br />performance ofconsfrucNon. "Thaf I am auttiorizad by the ownerofthls praperty fo perfotrt� the ����D �-� �`� <br />work fot wn/cfi appllcaUon ls m�de and ! comply tvlfh fhe Sfate Contracfors �.aw '18.27 RCW and _ <br />296.200 WAC. ' <br />� tU4�.��.t+�^-- �" �� �` (� <br />, S gnature Oa a ` <br />a <br />ABY(5EF 0&�8,+?0 f 4 . . � � . . .. <br />. . .. _ ...... . ___...... <br />_ __���v`� __ _ _ _ _ _ _____ _ _ ____ __ _ . _� _v__ _��,--�-__� _.__ _ _�_ __�_ __ ._. ____��� <br />