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� � <br /> — -- - - � <br /> i <br /> ' ELECTRICAL PERMIT APPLI�ATION � <br /> CITY U�' EVERE7T PERM17 SERVICES i <br /> 3200 CEDAFt STREET, EVERETT, WA 98201 � <br /> I 425-257-8810 - FAX 425-257-8857 - www.everettwa,org <br /> I, <br /> , 1� o. : � '(t �,�{' Q�JA > i <br /> '� PROJECTADDRESS <br /> �p�,,�� �. <br /> I � / � � I�(.�.� !� n 1�o- �' Gl -a�l C.SU�•2�Tl S�A__J„k2'-i—`� r�-& � <br /> � Meil ACErebs Ciry 5latel2�F P�one <br /> Owner <br /> I — <br /> � Tenent Mail AtlO�ess Cny State!Gp Phor.a <br /> I <br /> CdIF S ! � ' � I� �O�ol S '/.+crn��y LAE�••»•a �.JA 9 � `tA f as3-s��-3aa <br /> Sl6ta/L�p P��n� : <br /> Electrica�CanlraCto� Med Aodrass S�.•�< "1. '�' i <br /> S/�'� �SuSL �� � � �' � /1� / 1� 1 � <br /> State Licensa Number(reqwred) Gry of Everen Business Licease Number(reuuired) I <br /> f SOC.oc <br /> �e'{A � <br /> proposed Use o!Building Conlrzc Price of Work <br /> - MP/lC V,lr. 1 3i 3�j�?-3�'Jl <br /> Squere Footege Qf residenila;��ew conatrutiloq ramotlet or addilion) Conlecl Personl�np�N�m��bair'f,E�m<d S,1Y�., r ( � <br /> Number of devices Qf low voltage) I <br /> • Dastrlption ol'R'ork to BB Done: ���A< < �1 e�., C � "� � `�� �t I <br /> I <br /> i <br /> I I <br /> FEE T I <br /> ; CITV OF EVERETT LOCAL SALES TAX CODE IS 3106 � J�. /� i <br /> �' •iereby cemly thaf 1 heve read antl exAmined fhls eppllcetlon and know!he seme to be frue AnJ I <br /> ' c,�ct A!I piovislons ollews entl oidinances qoveming thls type ol woAr wlll be complefed ----1 <br /> wnulher specified herein oi nof 77ie gren(ing of a permd does nof presumo fo give au(hodty fo PERMTT# O�� I I <br /> mo�e!enrcencellhepiovis7onso/anyothers(eleorbcellewregulatlnyconsfroctiono�the � '�O�_ <br /> pe�+n�m�nce ol conshucflon. fhnt I am eulhodzad by Ihe owner ol thls properfy fo peAonn Ihe <br /> '� �o� .vh�ch appllcatlon Is metle antl!comply w'Ih tl�o Sfato Conhecfois Lavi 1827 RCW and <br /> :'�r, Tp0 wAC. <br /> �/;���---- y/, i�� i <br /> � -�- -' ignaiure Date � <br /> af vlsEo oLJNtola __ <br />