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_-� -- � <br /> - —_._ _ ._— _ ---- � <br /> � ELECTRICAL ,PERMIT,:APPLICATION,. . . ' <br /> ; <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEHFii, WA 98201 <br /> ; 425-257-8810 - FAX 425 257-SE57 —www eve�ettwa.org <br /> I� G` /.S/z—/ZS <br /> iz��7��5 <br /> o�`-� I lo a o` am s q v-�-- I <br /> ��, PROJECT ADDRESS i <br /> ', l���C. `t �I-L ��-�- ��� ' � � �`� � I <br /> ji Ow�er . Mad AHdress Ciry . State/Zip Phxe 'I, <br /> , '6�dnt Medqatlress City StafelZlD Phone � <br /> i <br /> ' j�+.v�a-,-� l�a.-I�nq y�o► s �3J-►'� t'�L Sv�J.41-� wo, 9 �el �os aoe a�18 �o� <br /> '� Electncal COMrector Madntltlress Ciry Ste�eiZ�o Pnone . <br /> ' +� � oaaa3 � <br /> I. Sta[e Licen56 Numher(reqar0tl) City Of EVerett Business License Num6er(requireC) <br /> SF2 �3� i <br /> �, ProDosed Use o�Building Contract Price ol Work i <br /> � m,,c. l.�o� . a� 6. -�u o� � <br /> ISQuare FOOt3ge Qf re5i4BnU31 new construcFoq remodel or addition) Conlacl Pers n/Contaci NumbedEm�� �.. <br /> INumber of de�iCeS(if low voltage) <br /> Descript�on ol Woric to 9e Done: 1 1 1 c�,�jl- 1I � �.11 � 0..�'�T�ti 1 _ <br /> I <br /> _ _� _ I <br /> FEE II CITY Of EVERETT LOCAL SALES TA% CODE IS 3t05 �� � <br /> V /( / � I <br /> � I heieby certi(y thef l have iead and exemined fhis Bpplicatron end know the same to be froe and //'� ' J <br /> correcG A!I provisions of laws and ordlnanres govemmg lhis type of work wll�be complefed — '� <br /> Iwhether specrlietl herein or r.ot.�The grantittg o7 e permit does nof prssume to give.authonry ro� vERMI7# �� <br /> violafs or cancel fhe provislons o�a�y ofher state or local!aw regWa7ing cOnstruction or[he E I�I L' I L5 I <br /> psrformance of consfruction 7hef I em eufnorizetl Dy Ihe Ovr�Br o!(his property fo peKomi the <br /> woik tp�whrch epphwhon rs made antl 1 comply wi(h thC Stdfe Confractors Law 18.27 RCW arid <br /> 200 WpC I <br /> SignaWre Da s � <br /> i <br /> i REvrSF00606/20I1 , <br />