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.� � ..v.. >o. o ' xo�.�.00.,a .ow� a� .o....ri .,�r....�,. .,, ... r...... o....., .v. n <br /> � • <br /> I'_ '____._'__ . �_ '--_" _' <br /> i <br /> � ELECTRIC�►L PERMIT AP�LICATIOt� <br /> � CITY OF EVERETT PERM17 SERVICES � <br /> 3200 CEDF�R STREET, EVERETT, WA 98201 ; <br /> 425-257-8810 - fAX 425-257•8857—www.everetriva.org � <br /> 3--i 2 --��( <br /> ��15 Gol6y r�V�. E�er.�-{-, �..�A. 5s2as � I�/03�-0.53 <br /> PROJECT ADDRESS � <br /> I <br /> �015 Golb�a�G. �Y�rr-�-k w,d . `a5Zo2 <br /> O�mer tdail Addiess C�ty State/Lip Phonc <br /> � � ��mba.�,�- B(drt i <br /> Tenant, Adaress , Gy SI�telZip ._ Phone <br /> lti;.�a�-�- G1��4�;�_ P.o. Box 44 G-�-�.�;��� �M1lls 1.�:�. 95Z5Z <br /> flle�ct if Cal Conlracter I,t;�d Atldmss CAy , SlalelZ�p Plwne <br /> I ,.;YA(TEZ9 -�SYD �x �� .�� <br /> State Ucense Number ConVact Pnce of Work <br /> � Froposed L'se ol Build�ng Coniaci Person (Plan Review) <br /> Square Footage(If residenual new conslmUwq remodel or atlqi6on) <br /> � <br /> I <br /> INumber of devices Qf low voltage) , _ <br /> Description of Work to Be Done: y.�5�� � FK�nv s�— �n.i s �- �TU . <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAA CODE IS 9105 .. . I I� � ,SO I <br /> V -� <br /> I hare6y cUiLly(ha(!Dave reud and exarnirmd thrs applicnHon onA know fhe same fo be fnrc and _____ <br /> cormct All provisions of laws and u�dinanccs goveming(his rype ol woA�will he cnmpleted <br /> whetl;er spealied Nerern or noL The granfing o�a pertnif does nof presurne to give aufhonty to PERMIT.. <br /> viola;e orcancel the p�avisions ol any otberslate orlotal law R?gulatmg conshucAon ortho <br /> peAormance o!construction. Tba!I am authonmd Dy the Owner ol this proporty to porfonn fho E I y o3 -o S <br /> w�oik for wn�ch applrcafron is matle and 1 compty�vith tho Sta�e Conlractors La�v 1827 RCV✓and <br /> 295100 WAC. <br /> �rfr� ,�.; � � 3/1 L/1-$ <br /> Signalurc Uatc � <br /> Hc��rseoa:cna � � - <br />