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C:5-:SZ-1666 C;dNEATI�G OG�07�.i9p.m. 10-06-:O1S 7iB <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREIT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—vavnv.everettwa.org <br /> (lL�� lA� �� � q0� � <br /> PROJECT ADDRESS <br /> �n�-�. ..�ofrinse,r� 50�� Dc�ac.000d nr Evy82o3 y25 327 �177 <br /> i Owner t:all nddress Cdy Stala2ip pnono <br /> Tenanl Mali Addics� Clry Stafe2ip Phono <br /> i11Glen�wU ( n� I'�� �racrlux�c.i ;ef f,t WA- Qb�1 4-2� Z�i �l �,G, <br /> Electrical CoNra or A1ai1 Addm�s Ciry S�a�e2ip Phono <br /> L'�11��MI�R�� 1,r.1 01 (�0� S <br /> State License Number(roquired) City af Everell Dusiness Licenso Number(requ�red) <br /> Z�U <br /> Prapesed Use ol Ouilding Contract Price a(Work <br /> �ehh i� �25 25� t���, <br /> Squaro Foolage pf residential new conslrUctlon, remodel or eddition) onlacl Person/Contacl NumbedEmail <br /> Numher cf devicee(If low vollage) <br /> �escnplian ol Work lo Bc Dono: I I��I I C�7�1 eSS �a'1' Q�l�N,(� I <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 rO � <br /> 1 bemby cerLty fhuf 1 hovo read and�xaminad Ih/s appffcalion and know!ho samo(o bo fine and J ` <br /> conuct. All provisions olla�vs end o�dinancos goveminglhis fype o/work will bo complo(ed <br /> whofherspeci�rd hemin ornot Thv granfing o/a pormif does not prvsumo to give aufhonty to pERMIT# <br /> violato orcancel Um prnvisions of ony ofhr�rs(afe orlocallawrrgularing consWction or(ho � I� �D J O, r � <br /> pedormancc ol consfruclion. Thaf 1 am aulhonzod by fha mmcr o/(his proporty fo perform fho 4 � <br /> work!or which opplicalion!s mado and I comply with Ihe Slefe Confn,ctor,^,Law i8.27 RCW'end � <br /> 296.200 WAC. <br /> --l�hu. 1��a,c 10 � �• I � <br /> �a�IJ1Y1C � � O�lIO <br /> FEVbE0f606:0�.1 <br />