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-- - � _ _. - -- � _ -- <br /> I <br /> i ELECTRICAL PERMIT APPLICATION <br /> ' CITY OF EVERETT PERMIT 5ERVICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 , <br /> , 4?5 ?57-8870 - FAX 425-257-8857 - �wvw everetlwa org <br /> I <br /> Ij Z S 2S c�K'S-f c�S;�v Rv� .,Q� t3�� I <br /> i <br /> ' PROJECTADORESS <br /> j _1 ���.5 (o1S 3rd Av� 5�;�e?� 5eat}l� �JI'� `t8(�`f z�-5�s_rx,3o <br /> '. Owne• �.tan Addiess Cdy Siate�Lp c�pa�e ��, <br /> I � <br /> __. .. '_'_..._' _"'__ '. ' _'__. _ ._ ___—"— '_ <br /> I Ienanl tdad Aa�ress Cdy State�l�p Phone i <br /> ,! p,U�1_c � l-t �' ►� _�o_�ox �n13(---�e lev�e ---�A 9 &�IS �s 6�y_9�� <br /> Elednca� L'onlractor } Ma�i Aaaiess C�ly SialMl p Vhore ;i <br /> (�l✓1,JL �5L � 5 `f.T�.—.__ ���`�;�c�. `�.51o33O° <br /> State Li�ense Number Con�rect Pnce of Woik <br /> 3�I( __3oc��a,,.. __--- <br /> ProposeA Use of Budling Conlac� Person (Plan Review) ' <br /> I --- -- - - � ---- - __._. i <br /> i Square Footage �tl resiAenlial nen conslruction. rernudel or addihon) I <br /> I — _ I <br /> 'i Nwnber ol Aevices(tl iew vnllagr,) � <br /> ;I s��o �v� � �� r�� L �' �' � ' <br /> n . . <br /> Uescr�ptian ol lNork to Hc l)o�ie -- _- -- _ -.�---�-�` - - <br /> i -- - <br /> ' �� 51�+� �. ���� �c�- —__ - -- -- - - ' <br /> --�- _- - - I <br /> --- _ .._ _- - - -- - --- _ --.— - --- � <br /> _ _ _ . --- <br /> � rFi=r , <br /> � CITY OF EVERETT LOCAL SALES 1AX CODE IS 7105 � � <br /> � �l{ �O I <br /> iI huie4y cerhly fhal I hn�e mad anA e�nmrned th�s apphcnGon anA knoro Ihe seme fn Ae Inie and ___ . . . i <br /> � eu�rer.f All provrsrnns ol lai+:c and orJrnances guvemrny fhrs frpe o/rvorw �edl Ue cornpleled --�— - ---- --- ------� <br /> whelher specdied heirrn or rrof 1"he y�anfrng u/a pennd does nof p�esume fo groe aulhorrty fo I PERMITu <br /> wo!ate or r,ancel fhe n�o�rsions ol any��1ner sr»te or Iece!�a�v mqulatrng cons�ruchun or fhe I ^ I ���� _ o,J ' — i I <br /> perfonnince of consfnicbon ihaf I arn authon:ed by the owner o/f/us proCeriy fo pedarn the t I <br /> worfi lor wh�r.h appdcobon is made anAl eontpiy�rdh 1hc Sfafrt Cnnhar.lors Larv 7877 RCW and . __ _ __ <br /> I79ti 700 WAC ii <br /> i L�/�'}]� � �/ 91 [/_� <br /> a��ynal re__ �`���------Dy�e ��2 � I�---- -- --- I� <br /> � ._rn �.ur. I <br />