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� • <br /> ELECTR�CAL P{�RIVIi�' �P��.YCA7"��i� <br /> CITY OF EV�F:ETT PERPi�iT SERVICES <br /> 3200 CFDAR STREE f, EVERETT, WA 98201 L�14,� [� -07S <br /> 425-257-8&10 - PAX425-257-8857 -v�vw.evereilwa.org <br /> L( --10 '-I �-C. <br /> 5��ll ����-, �e�J w�AY <br /> PROJECTADDRESS m�-`�� �S�"�Np <br /> �P�s-�r1 _ �Atit�=; �1��s ���oo 'I lo;�-1 �-s� sv��l��t'o � <br /> Owne� MailAddress City Slate/Zip Phone <br /> T1-1�F-Y -«T�G� �G.1 Zc �,�1Fla1P��1 sv�Y �YEIr�t�,w�t— �r f���' <br /> Tenanl MailAddress City SIatNZip Phone <br /> F�,a�. �lv.`�'(,W� 2�"'� <br /> �p DN� C.O'�1� 1b2� S �i41sT" �-, � °�2�1' �1�tZ- �'P <br /> EledricalConiractor MailAddress City S1ate/Zip . Phone <br /> State�icense Number CoNract Price of VJork <br /> Tv1'�� <br /> Proposed Use o(Building Conlacl Person (Plan Revievi) <br /> Square Foota9e (If residenlial nev�conslruction, remodel or addilion) <br /> Ivumher of devices (1(low vollage) <br /> Description of Work to �e Done: �- �T s1�i� <br /> r-Ee <br /> CITY OF EVERETT LOCAL SAL[5 TAX CODE IS 3'105 �� ��� <br /> I hereby cerii/y(hat I have�ead and examined this applicafion and know fhe same (o be(rue and <br /> correcL All provisions o//aws and ordinances gooeming lhis fype o(�vork will be compfeted <br /> ivhelhe�specilied herern or noL The granling of a permif does nol presume(o give aufl;orily fo PERhIIT# <br /> violate o�cancel(he provisions olany ofiier sfate orlocal(a�v regulaling cons(rucfion or fhe ^ '� O �_ ` f\� � <br /> perlormance ol conslr�ction. That I am aulhonzed by Ihe o:vner oI�his prope�ty lo pedorm Ihe t �) <br /> work/or which applicafion is made and 1 comply with the State Confiacfois l.aw 18.27 RCW and <br /> 296.200 WAC. <br /> `/ h lo lq' <br /> Signature Dale <br />