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�- -- <br /> - -_ __ _ - ------ - -- -i <br /> ELECTRICAL P�RMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br /> �1 �227 ��da� � � • <br /> PROJECT ADDRESS <br /> � �\ ! / 1 <br /> Vf�c.��..c45,� �ZZ> �LdCr 5�_ E`ic(�c t' -- ----- � <br /> Owner Mad Atldress Gly Slale2ip Pho��e 'I <br /> ienant Mail Address G.ry _ StateiDn Phone <br /> '7ib}-r -• t'T-s�-�--�--'T-��'e3—iy�--�f�i� � <br /> �v �� �,.d E�«b�� yo33 se«�< <�Uy `yaHuood (,�{� Gv�tc"1 70� s'7i.6��� <br /> �— Slate�Z� Phone <br /> Fleclrical Contractor Ma�l Add�ess � ��N P <br /> ' �P� �ET � qz� �s C.�S_ (�� ----- <br /> State License Number(reGwred) Cdy of Everett Business License Number(requ�red) i <br /> /�c',. k c�cc.. 5�,� —�-5� ��- — — i <br /> Proposed Use of[3wlding Contracl Pr�ce nl Work � <br /> Yw.� <br /> ZCb 5'(1. 6165 � ��5�.,,.d d<<d;�(�_ <br /> Square Footage(If residenlial new construclion, remodel or adddion) Contac�PersoNContact NumbertFinail �,�4w,��. �,� <br /> Number ol devices QI low voltage) I <br /> n /`� e t a.l � (� <br /> Descriphon ol Work to �e Done� �V � � "�� 2� �"^t" `ZJ v �� L�Cw� S 1 .---_ -- , I� <br /> �vt� C ¢ct��Qc.`CS _ <br /> FEE � <br /> CITY OF EVFRETT LOCAL SALES TAX CODE IS 310: I �I �� � <br /> l <br /> I hen�by ceridy fhaf I have mad nnd exanrineA Ihis applicatinn and know fhe same lo Ae fn�e anA ._. ._ —.___-_. <br /> correct All provisions ollaws and ortlniar.ces goveming Ihis type ol worN wdl be conrplefeA -- ------ � - <br /> whefher speci(ed hcre�n or nnf 1ha gmnfing ol a pomtd doas nof presuma fo yive auN�onty to P[RMiT# <br /> viufafe or cance/(he proas�ons ul any ofher slafe orlocal law regulalin�constniclion or the r�� � � _O�� <br /> peAonnnnce o/consfn�cNon lhaf I am aufhonzed 6y the ow�nero/this property fo peAorm the C <br /> work fur which applica(ion is made and 1 comply wifh fhe Sfate Carfracfors Law iB 27 RCW and _____ _____ <br /> 296 200 W/1C <br /> ��� `' _ 12 r� �Y <br /> giq Uat <br /> arv�trcnsov�c�i . _ _ I <br />