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ELECTRICAL PERMIT APPL,iCATrON <br />CITY OF EVERETT PERMlT SERVICES <br />3200 CEbAR STRE[T, EVEREl-i, VVA 98201 <br />425-257-8810 - FAX 425-257-8857 - wv,n�a.evereUv�a.org <br />_� 31 Z ��-�-vvt o rzz /�-v�. <br />PRO�ECT ADDRESS <br />l,J�-r � 1-1 Q� rl�-� 2 e,�c.._ E s ta-t-�. <br />Otvner 'dad Atldress <br />�Gi Cl-� � <br />Tenanl Liail Address <br />I<�c-c�eT�c C'n �d6�y�, 3�z <br />E:IeclricalCoNracto! �Aa�iAddress <br />K✓�c.����i`TZc.J� <br />Sta;e Litense Vmnber (required) <br />,�-�` Q2s�de,-.c � <br />Praposed Use of8uddmg <br />Ciiy <br />SILVG✓1S <br />City <br />c> �S'/0—zt� <br />/�� a9 ��5' <br />I.�A �(25 <br />Sialc%Lip <br />SlatelZip <br />Phenc <br />Phone <br />�J� S5r z�s� <br />Slale2ip Phone <br />D�Z-/O!� <br />City of [verett Gusiness License Number (required) <br />� 3 , �p o0 <br />Contract Prce of Work <br />J o0o Vnc�, I�.ad�..{ '�ZS-5o3-y�� <br />Square Foo�aye (I( residenlial ne�v consiruction, mmedel or addilion) Conlact PersoNConfact Number/Email <br />Nmnber of devices (If lotiv voltage) <br />Description of Work to Be Done: �✓� S Tirt�l- _ I.�,�� b rq h C l� C i('C i.t.0 � S <br />+o ✓'e.(� �c�ee lLhoS a- � be �uvi.d-uelw'S --- <br />�, — --- <br />FEE-- - ------- <br />CITY O� EVERETr LOCAL SALES TAX CODE IS 3105 � l D� <br />I hemh�� ce�li!}� lhnl ! hr�ve re,�d and examined (his app/rcaliorr and knmv the saroe fo he ln�r. and `� � <br />corror,t nll pruvrsions oflm•+s and o�dinances go�rrning Wis type oI wo�8 wili he complefed — — -.- —_ --�--- <br />whellie� spccified herein or noL 1 he granlin,q oI a permil does not p�esurnc !o give au(hoiity (o pERI•111�Y <br />vialale or canr.el the provision; o/any o(hers(ate orlocallaw re�ulalinc� cons(niclion or Ihe <br />perleim,�ncc o/ ccnsL!iclien. Th�t I am aufhonzed by lhc o�rner o((lris propcily tu per�lorm I��e E � i/,( D..2(-'j <br />r:ork lor u�hir,h epplir.a(ion is nwde ;md I comply wi(h fhe S!a!e Conlrac(nrs Law 18.27 RCIh� �nd 6 I <br />29G200 tNAC. - <br />V�C�l c�t�_----- v Ci- 2. �% 2 D!�j <br />SiynaWrc p��� -- <br />Hli✓,S[o0ACG9Jra <br />