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B�/27/2�14 08: 15 2�69575105 B�UE SKv I7I PAGE 02/�2 <br /> • � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PlERMIT SERVICES ��y0���6 <br /> 3200 CED/1R STREET, EVERETT, WA 981.01 Q`a��� <br /> �125-257-BB10 - FA,; a?.5-257-6857-www.everettwe.org <br /> �.3 U/Lj�/B�� �� � /� � �''�Z Z/��/N� �-� <br /> J'On`j �.tT^�5% �S/�c� � l�j, CII�L�� �—t/�- 90� <br /> VROJECT ADDRESS <br /> 1���-- � � 1�vX .37�7 �/ �-ti� �����/ <br /> Owner MalACtlrcae CiN S�ate2lp Phwio <br /> ��� � . <br /> Tenanl Mail Address Gty S�eteZp Phone <br /> va��Y�'�-.�i?� 33Is s,//6��S% �'i 2� s�hiZ.�; L�jr 91�i�8 <br /> .---�- <br /> Electnpi Contractor �A8'I ACdRS9 Crty ' S�amiZip anono <br /> �. r�ts.�� 9�z � ,� o�79oy <br /> Stete Llcenso NumbM(roQuired) Ciy of Evcrctt Bueinas License Numbe�(reqwred) <br /> �`=7 I�'c- S� � �o�, ��S � <br /> Proposed Usc ol�uildln� Contract Prlcw a1 Work <br /> Syuore Footnge(If residennal nwN consWch�on, rxmodxl or adAd'an) Conlact PmsonlContad NumDodEmall <br /> Nu�eviCC9(If low volL�po) <br /> oa�vuo�m wo�k ro ec oo��. —��5 �Zt J�UI�(J !//�CJ�¢L �'�,�U/t�.�7��j <br /> — �— �y " � "I �Z. /�°`' ^ �'_Lc (Jl�/h/l <br /> C�(C�,�� � .��,5 ��V[.L_���..�i�_��_(�� <br /> UvC���'� c�i�aJ�, - - <br /> hEE <br /> CITY OF EVERETT LOCAL SALES fAl(CODE IS]105 (�O� <br /> I hemby ce�fily thnf l hovn reod and examrned Mis epplicuGon nnd Imow fho samc fo be Wc nnd <br /> J <br /> conucL !II!prowsions ollaws and ordlnancos govem'��g fhis typo ol wwh wifl be cwnplefed <br /> whefher apccified hero;n or not. Thc pronfinn o!a pertnif tloea nol presume ro pivc nufhoNfy lo PERMITA <br /> violafe or canco/Vw proNs�ons o1 any oNor sfeto arlocal law rogulatmg construcfion or fho � I�oA ' ( � ! <br /> prrhvmancV olconstrucflpn 7hat l am auMonzed by fhe owncr o/(his property ro pc�loinr Ihe U ��7 <br /> work for wfilcA uppllcollon!a medo ond I eomply wIN flre Slefo Contrectors Law 18.27 RCW end <br /> 296.?00 W C. <br /> Signal ��� .T <br /> aewsru ooa»oi. <br />