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�-- -- —� — _ _ -- - <br /> I', ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES , <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I <br /> I 425-257-8810 - FAX 425-257-8857—www everettwa.org <br /> � <br /> II <br /> 'I �% � Co (by 7g✓� � <br /> iPROJECT ADDRESS <br /> � SK.o�I-�.l �1-�ujr��seS P.o, Qo,c sas i G�e�e�f� l,J/� q��o6 <br /> Owner I;�adAdCre,s CAy Slate2�.p Phone '. <br /> � �ro�ura ayay C�I�yf1✓e ir-ver�c � InIA 9�aa1 <br /> , <br /> I Tenant 6:a�lAddress Gty State�Lo Phone � <br /> I'� �2l/�� Sic��'1 SyS�f'en�s �00�1�01esov� �„ �Uef�G�F Wy �(.���(, .F�3S` <br /> Eledncal onU tor t:a��ACdress Ciry Slate2�p Pl,one <br /> i 6�1�2+1N��es�s��3 o�y � $6 �� <br /> State L�cense Number(reqwred) Gty�Qf EvereK Bus�ness L�cense Number(reqwred) ' <br /> ICOwiM�rclq( 7� �� 000, � <br /> Proposed Use of Bwldmg Contract Price of Work <br /> j�. 3 � (s��� ) 6/r��a�,�s _ <br /> Square Footage pf resi en6 ne construd�on, remodei or addition) Contact Person/Contatl Num�eCEmad <br /> i Nc"wPr-Qin�rs���ie�y��aNs y �N'S <br /> . c:r, <br /> '� Number o(dewces pf iow voltage) �ar��6 ��3r <br /> I Desu�pt�on of Work lo Be Done (vt S�G� �' (�✓ti� (��1 �� ..SI a�1 ��I <br /> I <br /> i <br /> FEE <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 f� !/�� <br /> f� <br /> iI hereby certdy that!have read and exanuned this aFPbcafion and knon•Ihe same to be f�ue and I <br /> coriecl All prowrrons ollaws and ordrnances goveming!hrs type oI mork wdl 6e compieted <br /> u-hefher speaGed herem or noL The granhng ol a permil dres nof presume fo grve aulhonty�o pERMIT� <br /> I violale o�cancel the prows�ons o�any other Stafe or local law regulating conshucbon or 1he , (. p' I <br /> iUeAo�nance o�conshuctron Thaf I am aulhonzed 6y the on�ne�o/th�s prope.;/to peAo�m the E � 'T � (j' �b S I <br /> �+�ork lor whic.h apphcafion is made and i comply wrth the State Confracfors La�v f 8 27 RCW ar�1 i <br /> 296 200 WAC <br /> � � ��-�---- � i � / <br /> Signature Ua�e i <br /> ,,:.._�_.sc�:;�: <br />