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� � <br /> � ELECTFtICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 `I� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org 6- Q a- <br /> C1�6 ��1� <br /> �o��Ula kll �off Wa.� h��ve. l-I- w;� 9�'L��3 <br /> PROJECT ADDRESS <br /> �u�'1c� ���eVcN� �`10b �.II;aFE wa.� L–�erc1"�' wA 9Y,Z��� <br /> Owner Mail Address Ciry SlatclZip f'hone <br /> t�-�uNi / QwfVEl2 ULCVP`l <br /> Tenani fnad AdJress Ciry Statc/ZiD Phone <br /> �'c�.T- TF_C�t (� 1 <br /> FLEcTC'1�-nL c.�:;.�;. +�D �F z`7f3-> l.�%CiCJ�1'�N��ill c,. l,l.!(_�. �t��'�� <br /> Electncal ConVactor PAad Adaress Cily Slale2ip Phone <br /> VOi.TT�S�:qZOV �S ZZ�, \ <br /> State license Number(required) City af Everelt�usmess License Number(reqwred) <br /> 1-aUv+tG � l��0�� <br /> Proposed Use ot Building Conlraci Pnce of Work <br /> � Qt:.c�.. 'ZtN.� �'�I Cil�i{ �f�r��lryrJlol'f- �-2< �� <br /> Square Footage Qf resideNial ew consirudion, iemodel or addil�on) Conlacl PersonlContact NumDer[mail <br /> NumUer of devices pf lo voltage) <br /> Descnption at Work to Be Done� ZLI-�C�IM P �? F Lr�-� 1Z � �r�1�1- �,i\t�(-.� � � p�r�lc [:v�n ElvT <br /> w / 2cx�hw�;� P��NE�• -- — <br /> FEE <br /> CITV OF EV[RETT LOCAL SALES TAX CODE IS J'I05 �j�� OU <br /> � <br /> I �huroLy cartrly fhn!I have read and ex�mmed(hrs applic�hon and hnow fhr. some(o be lrue and _ —_ <br /> correcf All provi;iuns o!law;and ordrnrmces yovem�ng Ihrs typo ol work�vdl ae r.ompfeferJ <br /> ' �vhefhr.r spr.ciGed herem or not. Tf�e g�anlrng o/a permd does not piasume to give aufhonty fo PERMITN – � <br /> �� v�ul�fe or cancr.l fhe provismns ol any olher sfsle or lor.al law iegulahny r.onsfrucfion or 7he r <br /> � �>afonnance ol construclion. (hat 1 am authonred Dy Ihe o�vner o!fhis propeny to perlorm fhe E �_J��p r Q' ( <br /> � w0�k/O/whiGh F7pphC�fiOn�5 maAe ilrltl I ompty�vrth the Slnte Conlrar.(ors Law 7y 27 RCbl�and __ <br /> 79G 20 AC <br /> � J' �/ � I J .��' �,. <br /> S�gnalure ,f Uaic / <br /> / <br /> 1� <br /> urNSEU exv57Jt, <br /> . _ . . . . . . . .. ...__ ._ _ <br />