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�� _ �. . zo,�.�,..... �, . ..� «,..�, ,,,,,,..,5,.,, .., , .�,.. ���.,.. , „ <br />� <br />� <br />ELECTRICe4L PERMIT APPL.ICATION <br />CITY OF EVERETT ?ERMIT SER��CES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257•8857 — www.everettwa.org <br />`1 � 1 1 �V.'/��1("C�r1 I CnY ' ��/P(t'�i-�V.%� . <br />PROJECT ADDRESS <br />II ,��r'l'So1 Sl-.oa0`•.� 4'��P� r.�nr:'� l.J/�.. <br />� Ownef hlail Adtlresa Gry Slale�2iD a�one <br />RPJ�'� L.;Ce-,ei�o� CJP!'r�"T W� <br />Terent htoi� qypress C+ry Stata2ip Phone <br />�{—E- Ele��r�� <br />Contractor <br />tdail Adares; <br />�Y�4-'('TEi.�1�F5PD <br />State License Number <br />Proposed Use of Building <br />Square f=ootage (If re�itlential now consWClon, remode! or addition) <br />NumbOr Of tlOviCCS (1( IOw v01Idg0) <br />Ciry <br />5Z <br />StatmZlp =�or�e <br />� �i(j G O <br />Contract Price of Vdork <br />Con!atl Perscn (Plan Rewe.v) <br />Descnpuon o` Work to Be Donc �n�ii a__g�, ,�_ o�:} c� �, ., ; 4-�� i-O c� 1.2 (? o i. ' <br />v „ �,e��. <br />CITY OF EVERETT LOCAL SALES TAx CODE 15 5105 <br />I homby CORJy thaf I have rBed dnd ox�nuned (hls uppllcalion and knoiv flru s�mo (o bo true and <br />concr.t All provisinns o/Imvs nnd nnlinonces goveinin� this fype ol v.�ork will be r.ornpfnleh <br />vAmfl,or speciiicd herein or noL The granling ol n pemuf docs nof p/esumo to givc nufhonry fo <br />vlola(e or cancel fhu provisions ol �ny ofher sfate orlocal law rogulahny conshucfion or fho <br />perfomrance o/ constmction. Th�it I am authonzed by the o�vner o/ Ihis property to periomt fho <br />wo�k Por which appllce6on is modo aad f comply H-ith fho Stato Gonfroctors Ldw 18.:7 RCW and <br />296.200 WAC. <br />� Sigr�atu�� <br />r.ev�sr� = : c, u <br />FEE <br />5� ��v <br />L_ _ _ <br />—_, <br />PERMITx <br />E i`�oa- ID3 <br />