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7i�2/2ola 10:00 �.�1 425 267 8857 C�'LRETP PER}!IT SERVICES @1001'001 <br /> ELECTRICl�L, P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT S�RVICES <br /> 3200 CEDAR SIRGFT, EVERETT, WA 982Dt <br /> 425-257-8810 - FAX 425-257-t3857—www.everettvJa.org <br /> l��O � S� t��1� T-1 ��.,�- � <br /> PROJECT AD�RESS � <br /> Owner <br /> MailAddress City State2ip Phone <br /> b <br /> `�S 11.�%�k-�C�' P�.G1G� - ��13"1P C��1'��- I <br /> Teoant Mall A dross CIly Slate2ip Phone I <br /> 1NIn� �C SQC�J�r��l-u �tiIS���S l�-I �a.f o m i�lo i�� � �c�l--I1e�� (�� ��� <br /> Eledrical Contrador :IAddres9 Clry Sla.e/Z�p ,^ l,_� Ph <br /> l..l T� �—�� <br /> W1-4ZT CSSO��-f I�P _ � I �� �4 r •� <br /> � <br /> Slale License Number Conlract PAco of Wo <br /> o��ce ��- mavsha.� m«rra� <br /> Propoeod Usa of Building Contact Person (Plan Raviawj <br /> � �IPIN <br /> Squar�F�F�tage If�esidential new consWction,fen)odel 01 adUllloP) � � <br /> Numherafdovi�s(Iflow�vollage) � <br /> Oescnption af Work to Be Done: �1 ,� Jl.���C? �'� � "'�� <br /> FEE <br /> r , <br /> �' CIIY OF EVERETT LOCAL SAtES TAX CODE IS 3105 <br /> ; l horoby codily U�at 1 havn rr�nd and exammed this appfication entl kno:v fhe 3omo to bo(ruQ and <br /> �� cor7ocL All provisions o(laws anQ oNinancas pnvoming tlils rype o/woAt wl1l De romploled <br /> whelho�specrfied hersin oroof. The praofing of a permit does nof presume!o gNe ouf6onty to PERMIfit <br /> vfolatoor:ancelthoprovisionsofanyofhurstatoorlocallaw/egvlsn'ngconstructfonorthe -, ;� .- � �� <br /> peAom�ance of consWclion. Thet 1 em authonzed by U�o o:merof fhis propeAy fo pedarm tho ���; I� ;' - (J � <br /> �vu,k Iw cvh/ch appl/catlon Is mado and!comply v.9th q�o stats contracmrs Law�a.27 RCW nnd <br /> 29G200 WAC. � <br /> ���� � ��aa ���' <br /> aWre Dale <br /> H6'(P.1>3'_G'13 � � <br />