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ELECTRlCAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-885 J– �vwi,v evereliwa or,y <br />�g ��� _ (n1-�-e � � � _ �� <br />PROJECTADDRESS <br />1�-1� � ��,��� s �� g��G� �� __�9��_�� �� <br />_ �--- -- __- -- - <br />Owner Mail Address Gty <br />Tenanl <br />17eclncal Contr;�clor <br />.`itafe I irense IJun�b��� <br />Proposed Usc of [iudding <br />nt,vl nddress <br />Id,ul �Jdm;s <br />—_ _ _' . cdy ___—_' <br />__.. . .—Cdy . . .._ <br />Sq��are Foulage pf residential new conshuclion, remodel or addiuon) <br />� � S-i4 <br />�w� yob,-o° z <br />5� 2.; 9.�� - 3(� <br />�✓/� --�� z L� <br />Stnlc2ip Phanc <br />$late/Lp <br />Slute�Z�p <br />_ _�( �._D9 <br />Cmhd�.� Pnce ol Wmk <br />Contact Person (Plan Review) <br />Phunre <br />i'ho�',c— <br />Number ol devices Qt luw vc�� �r,) <br />Da. sciiption ul Work lo He Donr, - - — _ �� P � .. �_ �� �_� -- �n � yv,� 9� � �I � <br />_ � / <br />�14 , G� �� � ( �� �e��� -- --- -- -- <br />f[L <br />CITY OF EVf.RETT LOCAL SALES fAX CO�G IS 3105 �D �� <br />I hrreby cr.rhlylh�f I h.rve read and examined fhis opplir.ohnn and know Uic .}n,,.,� fo br, fn�r, nnrl — .--- ._ —_ <br />r.urrecf 1111 p�nvisinns oilaws and ortlinanr,r.s novrnuny Ihr.s fypc ol wnrk wd� br, cun:plrh�d — ----- �- <br />whefhr.r specilied hcrenr or nol The qrenliny ol a pe�mrf doct nof presumr. !o grvc uulhonty �n PFRMII ti <br />vi0l.de ur canr.el lhe provisions n/arry olfrr.i s:;+fe orlucal law re�idnlin� cnnshuc6on ui Ihe r <br />perlonnance olconstrucGun. (liaf I nrrr ,�ulhorveJ 6y thr, nwnr.r o/ fhis p�opeily lo perinnn Ihe t� I l.f 0�_� i1 � <br />worN lor which appbcahon is rnadc ond 1 r.nmply wdh Ihr. Sln(c f,onlretlms l aw 1 R 77 RCW �nd _ v <br />79G 200 WAC <br />i� �� ^- y' �!/ - � �_ / � / _ <br />Siqnaliim� lnfe � <br />C/ <br />