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• <br />s <br />ELE�TI�ICAL PE��iT AP'�'LICATIC�N <br />CITY tJF EVERETT PEFtMiT SERVIC�S <br />32Gp CEDAF� STREET, EVERETT , WA 98201 <br />4�5-257-88� 0- FAX 425-257-8857 — www.�verettwa.r�rg <br />, <br />�-� Cj t�' _ �r � r �;_�-?- �':� ! :'�' ' - <br />PROJECT ADDRESS <br />pv,mer <br />i' r <br />f , ,`S (M. k' ..,.i:rv. �" ,$��t,f.'r� J c <br />.Y.: C, <br />ienani <br />i�tail Addruss <br />� -�`` � ��. 1.,,, %`, t..� � �. „ <br />M1Fl�iI Addr�ss <br />City <br />�'��t`l � �� . 1 (t �� � <br />Ciiy <br />slatc�zip <br />�ff1 �tr�ls r �.. �'�.' l <br />51'r.1lCJZip <br />Pr,onc <br />`� ��,..'��. <br />Phqne <br />��.a.t{ r�ec fc1 � �r- {� ., � Z'"'' �'� S�� � r1 _ 7 c' c.�' ,Ga� .� �� c� , i, �r ,„ �. �/ ' <br />f. � t` .� ,• �._.. ry C., �'t l�� r t �� <br />ElecCncal Cnntractor h��+�i �ddrr:s:. C�ty Sxa�f�2�p �ncme <br />����i � e�" �` � t�,,� � � � t� �'_.._ <br />St�te Lic�nse Nurriber (r�,quired} <br />Praposeri Usc: <�f t3uildiny <br />City c}C Evereti Ciusin�.ss LicensF. N�irnber (required) <br />y, �., <br />� ' y' C> <-.� ��' <br />Contr��t:t Prir.e of Work <br />, �. �� t;. �' � c ,,. , ,'� z`• t` ` c� �,11 .5� ' if"�P"� -- �'!1 �'',.. <br />Square Footage (I( residential new constructiori, remodel or addilifln) Gonta3ct Person/Conlact Nurnberl(�mail <br />Number of devices (If low voitage) <br />� ' <br />J 7 , <br />Descriptian af Work to F3e (�one _1'��-� � �dr— � U� ;r : r�-� �'^ (,, ,:�. l �,, r ,^• C c ; �-` - <br />CITY OF EVERETf L�CAL SALES TAX C(7DE IS 3905 <br />1 ircreby ccrtify fhat I i�av� read and examined this apptrcatron �nd kno�v the s�me to be true and <br />correct. All provisions oflaws and ordinances governing ttiis lype of warh rr�ill be carrrplefed <br />avh�ther spec�ed herein or not. The granting of a�ernart does not prescfn�e to give autharlty to <br />violate or c��ncel the provisians of any olher stafe or loca! law regulating cpnstruction or the <br />ptrformance o1 construcfion. Thaf i�m authariz�d by the o�:�rter a/ this pr-qperTy 10 perform the <br />tivork fnr irhich applicatron rs rnade ar�d f comply iv+lh tne StE�Ce Conlractors Latv it�.27 RCW an�l <br />296.200 i�YAC. <br />[ <br />�"� '� /` � ��... �:� .� � � r � � �.�� <br />4, <br />...y. .. <br />rRc� vi.�;F� GS.?`iU^0! a <br />�c� <br />F�E <br />f �Z�c� <br />PERMIT� <br />E � 5�`-� - 2�� <br />