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. • <br /> 1 <br /> _ ___- ________ <br /> ______ <br /> __ ____ _ _ ___ _ � <br /> � <br /> � ELECTRO�AL I�E�IVII7� ��'��..9�AT'VC�� I� <br /> i � <br /> � CITY OF EVERETT PERMIT SERVICES ! <br /> 3200 CC-DAR STREET, EVERETT, �VA 98201 i <br /> � 425-257•8810 - PAX 425-257-8857 —www.everettwa.org <br /> I � <br /> ! , �.JQ,�:{-I- ulc�- q �daol I <br /> Z2`Z,� Co rv�vn�r^� I <br /> I PROJECTADDRESS i <br /> � �,.��a�mr " fla a� . � .S�.�t�n ' �uQ �:/erz--f� �� � �a�� <br /> i Owner MadAddres, City SlaleiZ�p Fherc <br /> �tas- a43 ! <br /> ' � � p��- `7 s" c� I <br /> ITenant h1a4Addiess C�ty StalelLp Phone � <br /> I1 �- ' . ,1 - �, I <br /> �S�Y�.�.--�-��� �1 �'� Ym�� 1��.�Q F��� ab i <br /> [IedricalContraetor h7a�lAddress Gty Statell�p Phone <br /> yas- <br /> a43=�� �� <br /> State License Number Contracl Price of'+:'ork <br /> i <br /> IConlacl Person (Plan Review) � <br /> Proposed Use o`Buildmg <br /> I <br /> I / <br /> I ` � <br /> Square Foota�enl�al n • onsfruction, remodel or adddion) j <br /> � <br /> Number ol devices (If lov+vollage) I <br /> � Descnption of Work to Be Done�. +!_�.m�.�(�-�--'�--"(--�`�1.1�lJ—�—�="+�=�Q�- - ---� ---- � I <br /> � � J I <br /> I,����—���1_��--cs-- - � <br /> � <br /> F[[ <br /> CITY OF EVGRETT LOCALSAL[S TAX CODE IS 7105 20 'v� <br /> I1 hereby cerLly Ihat I have read and examined(his applicatio� ard Fno�.v the same !o tre hue and ' <br /> conecf Flll provisions o(la�•rs and ordinances governing this fype ol�:ork nill 6e cornpfcled I <br /> �vhefher speci(ied heiein ornot. The granfing o/a permd does not presume to givc au(harity to P[RMIT� I <br /> v�olafe or carcel Ihe provisions ol any other sfate orlocal la�v regulating�onsfnicfion orthe � � �( ,17� J i �� <br /> e�lermance o/consfn�ctimi. Tha(1 am authonzed by fhe o��ne�ol fhis roperfy to perform fhe `�V <br /> �•� rk lor which appGcation is made and I compfy wdh!he Stafe Conhacfors Law 78.27 RCW and � <br /> 29 200 WAC. Q� . <br /> �,;�, �« -� - -�a��� I� <br /> Datc <br />