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ELECTRICAL F'ERMIT AN�'LICATION <br /> CITY OF EVERI=TT PERMIT SERVICES <br /> 3200 CEDAR S fREET, EVERETT, WA 98201 <br /> 425-257•&910 FAX 425-257-8857 — www.everettwa.org � ` �a—/,S <br /> �c /S"��-L� � <br /> �!O� �J. C,91.T-�/o ��-.�. <br /> PROJECT ADDRESS /'� -•�� <br /> c, <br /> 1�lF,�/� - .1;��� ��9�/A'D �Jd�� Fv,�. <br /> " —�--- - <br /> Owner Mad Address Cdy Slate/Zip PM1one <br /> �,%OG-<�c/ f7�LG--//,� _/ !�/oZr7 G'�/n�'dT Gr/,�. <br /> l" _ �- -- — <br /> Ttnanl fdailAddress Ciry SlaleiTip Phone <br /> �- ?�� � G3j- d'ir7 <br /> ����tiv�.t'.�.�., �.�� F � � � f�;,.��� � id7 _ <br /> Fledrical Con�rador Mad Addies� City SIa1c/Z�p Phone <br /> ��FX��a s�.,��� D�o�- - --� <br /> State License Number(requned) Gly o( verett Ausiness I.icense Numbei(�eqmred) <br /> _����-rv �-- - <br /> ��F��� - — <br /> Propased Use ot Duiiding Conlfacl Pr�5c of Work / <br /> F!'i.0 //i./C/c�-Y <br /> �uG G✓�d-,�,fiu ..�'/llui/�t/� ar✓�,'��4h <br /> So��aie I�oolage�II resiAr.nl�al new conslnichon, remodel or addiUon� Con�acl PeisonlCon�act Numberl[meil � � <br /> �� <br /> Number of devices(If Inw vollapc) <br /> Descnption of Wmk to Elc Donc _s-��Ii�/J«- /�i���Ci,�i2..� _f f1Tc��.=�_ . .-- — -- <br /> N GC� /_.�'� l!N% L-.:7.J� _ Ci c�L"��a f�_ ..—_ --_. .. ___ ___ .. <br /> �FE <br /> CITY OF [VERETT LOCAL SALES TAX CODE IS J105 I Q� •% D <br /> � � <br /> I hcrrby r.crh/y Ihaf I hmc rr��d�ind rrurrrined fhi;appOcu6un rmd hnuw Nir. :;nnm lo bn fnw ond --- -- -----_— —_ <br /> cnnecl All proasions ol I,�ws nnJ onhnarrr.ns gnvcrnrn�lhis typr, ol work �vdl hc r,ornplcfcd - - -- - - <br /> whefhci specr/icd herorn oi nuf llrr, y�nnfmp ol 'u pwrnd docs rrut presumo lu 4�ve aufhunty fo PERMIT!! <br /> violafo ur r,anr.el Ihr, p�uvisions ol�ny nflrni slafe o�lor.�I Inw reguliting conslruc6on o�fhe � <br /> peAnmianr.e�!ronslnictinn Tha!I,vm nulhon�cAAy Ihc o�vna o/fhrs property lo per/onn fhr 15 6 I —�J� � <br /> wnrk lo�wfuclr �pplu:nGnn r•:mnde.md 1 cornply wilb Ibc Sfnfr, Confr��cfors Law 18 27 RCW�ind _- . --.--._--. V � --- <br /> 796 200 W� ' � <br /> '� f �/,��_,a���s . <br /> -�--� � <br /> _ - - - ---- -- - ---- — --- <br /> Siqna�ur DIIC <br /> � r�vrtrnu,�v,,,,ur.� _ ._. . . _ . _ . . _ _ _ . � <br />