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� <br />�J <br />ELECTRICAL PERIVIIT APPiLVCAT'IC�f� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STR[ET, EV[RETI', �R�A 98201 <br />425-257-8810 - FAX 425-?_57-8857 — �'rvnv everettwa ory <br />3 �� �'�er�c ! �lve <br />� <br />PROJFCTADDRESS <br />l�Zz <br />Owner <br />Tenanf <br />3 0� F�d�f'4 ��4 v� <br />� ✓ ere � l� � °�Z°/ <br />A1adAddress Gry S,ate2�p Phene <br />(�'�)�?0-73 <br />f�lailAtld�ess C,ty State/Z�p Phcne <br />P�(p.P�i � C T�✓c ��i y� �ZyP.�<�� �.i (ZZ��t,�� �,�1�� �%�i��'��, <br />EleclricalConlractor �dadnddress <br />ys',a� 2z 9�6 � � <br />Stale License Number <br />Propesed Use o( �uild�ng <br />II�Z � <br />Squ�re Footage pf r sidential nevi construction, remodel or addd�on) <br />Number ot devices Qf lo�•i voltage) <br />Description of Work to �e Done <br />C �y <br />Stale2�p <br />r <br />�, �.� <br />Conlrac! Price of �Voik <br />Contact Person (Plan Revievr) <br />s.-�-'�;.� �C �4 �D � R a �/� � �,�� <br />� . � �-- <br />rer,a�r W��r���c{ <br />CITY OF EVERETT LOCAL SALGS TAY. CODE IS 3105 <br />1 herehy certdy flret 1 have read and examined this apolicafion and know fhe same (o be Nue and <br />coned. All pravisions o/la�vs and ordinances goveming (his f}•pe ol �vork �•nll Ue completed <br />�rhefher speci/ied he�ein or no7. The granting ol a peimif does not presume (o give a�dhority lo <br />�nolafe orcancel fhe provisions ol any ofher slate or/oca/ law regul4�'ing cons(ruclion o� the <br />perloimance ol constni n. Thaf I am authonzed by fhe o�vner of fhis properiy fo peAoim Ihe <br />work le� �•✓hich a on is rnade nd I comply �:�dh (he �fafe Conhacfors La�v 18.27 RCW and <br />296.2G0 W <br />/-�� �-Z���/ <br />we uaie <br />FEE <br />�(� CO <br />U <br />PERh1iT?t <br />E I�,� ��{ o�f - vv; � <br />