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—�— ----- �---- <br />:LECTRlCAL PERMIT A,PPLICATIO(V <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www everettwa.org <br />-7021 c�(�RC�atz-r.1 �JRy <br />PROJECT ADDRESS <br />Owner <br />Atad Addms, <br />Gry <br />State2p Pnone <br />a� ���a� la� 7Fi2� F�cRC �Z 1 wRy <br />Tenant t.1aAACaress Ciry StafefLip P�one <br />[IeeinCal CoNtactOf t.tad Address <br />' ('�rSiS� `�`1G1� <br />' State License Number <br />' Comrr��+a� 1.5 � L �) <br />�� Proposed Use ot Bwldidg <br />N1a <br />SQuare Footage (If residenhal new conslruct�on, remodel or addition) <br />Numbcr ot devices pf low voltage) <br />Gty <br />� n�,u� cu�� � <br />State2�p <br />� Q� � <br />r� <br />Contrad Pnce ol Work <br />������ �13 R, i I <br />Conlacl F"rson (Plan Review) <br />DescnphonolWorkloBeDone. In51'C��I C�1"1� [=/:1� SI'�1� CI�S,t� 0.. <br />7" / <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />I hrreGy cmhly thal l have mad and exammed fhis apphcafron and Fnow (he sarne to be lnie nnd <br />co�r,d. All provisions ol la�vs and ordinances govemmg this fype ol work vnll be cornpleled <br />whe�her specifieA herem or noL 7he yranhng o! a pemuf Joes nol p�esume to give aulh�nty to <br />wola(e or cance! fhe provisions ol any other stafe or local la�v regulating consfruc(ron or the <br />peAormance o/consln�chon. Th.af I am authonzeJ 6y fhe owner o/lhis property fo perfomi the <br />wark lor which applicaf�on is made and 1 cmnply �vdh ihe Sfafe Contracfors Law 79.27 RCV✓ and <br />296200 W�C. <br />��� p � 3 , <br />"( ,' ( X ��iD ��4 � ���� �� <br />r.,v;sr.o iaa❑ <br />3jo. � i K� <br />Phone <br />FEE <br />�0•D� <br />PERh1fTu <br />E � `� �7'07 Z <br />