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, - - - --�-- _ __� ---- - �� <br /> � <br /> i ELECTRICAL PERMIT APPLICATION i, <br /> � CITY OF EVERETT PERMIT SERVICES � <br /> I 3200 CEDAR STREET, EVGR[TT, WA 98201 i <br /> i 425-257-8810 - FAX 425-257-8857 -www.everettwa org <br /> i <br /> ���l�a— �y' , <br /> 1�422 �� � __ /a—�o —�� I <br /> PROJEC:T ADDRESS <br /> � 52nn�� �i(.Q. LP42Z �� /_ e � w (Bs� � - <br /> Die�r� _�-- -� r �v _L� 777��y,, f�— <br /> Owner � Mad AAAress Gty SIaIc�Lp l� �7/'�� P��one <br /> 1 !� <br /> _'__.._. .._ _—__ . _. _—_'__ '___.—_' '_ _ _ -_._-_.. -__ <br /> _' _ . _ <br /> ' Tenant Mal�AAress C�ry Siaie�l�p �'none <br /> R�IuZ �1�YY1�_�n�1��_��'"-StSu�# ���innflaKe. �er►'�c� W�" C��) <br /> �--- <br /> Eiectr�calContractor � ��� �.�a�� aa«55 ���Y �s�,�P,��P q�D.43 ��,�°��� —7i3� <br /> ����FFt�g�v� 6(�. —sz�`t� ----- <br /> State License Number�reqmred) C�ty ol Fverelt Bus�ness L�cense Num6er(re7mred) <br /> p0 <br /> __ -- _-- - --- <br /> Proposed Use of f3wldmg Conlract Pnce o(Work � <br /> �QY11� ��. QG,�P.fS ��L(.� �IG1 f� <br /> Square Faolage(If res�dential new r.onsVudmn remodel o� addition) Gonlacl PersoNConlacl NumbedEmail 4��� � - <br /> ��� � 1 <br /> � <br /> Number ol tlewces(If low voltage) I <br /> Descnpt�on o�Work�a t3e Done _ I_Y�1 J�I l/1�I _ � �t'W� l.i-1 V v� � �__-1-�- � N V� �v. - y �t�- � <br /> - __ - �-'� m� _ <br /> FEE -- ----, I <br /> CITV OF EVERETT IOCAL SALES TA%CODE IS J105 �`O D� �I <br /> ��J <br /> 1 hcreby Cerbl��Ihaf 1 have iead and ex.vnu:ed Ihrs epphr.ahun and Fnnw fhe sarne fo br vue anA ... . .._ .— - <br /> conecf All piovis�ons ollaws and orAinances govemmg Uus(ype o/wo�F wdl be conrplefed f ------ � � ---�- - <br /> 1VIIQIIIB/5(1BCIIIP(J IIYIEIl1 OI IIOI The gr�nhng o!a perrnd Aoes nof presume fo qrve aulhonty fo I �P[RMIT# - � <br /> vrnlafe or cancel dre p�nvisinns ol any o(he�sfale o�locall,�w regulahny conshucfron or Ihe I ^ � ��o ' � ,/ <br /> pe�formance ol construr,Gnn Thal I am auf��orrved bV fAe owner ollhrs pmperly fo peAorm Ihe I t 4� <br /> �vork lo�wbich apphcabon rs maAn, and 1 complY wifh fhe Slale ConVncto�s l.�w 18 27 RCW and . ___.___ <br /> 296 70U WAC <br /> �s�gnawr� e_-- __ oal U _�Q �`"T' . <br /> aeu�scnoeveaou .___.__._ <br />