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( <br /> ELECTRICAL PERMIT APPLILATION <br /> CITY OF EVERETT PERMIT SERVIC��S � -�-s��3 / <br /> 3200 CEOAR STREET, EVERETT, WA 98201 ��3p�—I a�0 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> l � �� <br /> I S � �-�.���� r� � � � w � b.� �� � � <br /> � ��� � �� <br /> P OJECT ADORESS <br /> , q � ,q �� � <br /> bl����" � VJ C_.c�ll�.�' vl I �t � �� G �i'��l-�^�_ <br /> Ownor MaP Addt..ea Clly Statc(4p Phonc <br /> LJ�• /h+'j--� '�� f J/'cCh�ti—c,` I� � SC� C�V"�('�' �`�`i��V � U <br /> Tonant �Mail Mdro'a Clty SUta2p � Phone <br /> � �..,a,l �_� ?�3 �- `�� <br /> E oc noal CanVado���n+e��� ( � I I S o�v�e..- s��ma 2ob Pr�'"� _ 815� <br /> � � �Zo a �s z 33 <br /> ���c r g �� ! � <br /> Str�tu license Number orthact Pric�of Work <br /> "D��-2 zq c.� v <br /> Proposed Usa ot Duilding Conted Person len Raview) <br /> � oo S y .�--� Z.,� � S�z- � °� � <br /> Square Footnpe(If ra enUal naw canstruchon,ramodel or addi6on) <br /> � <br /> Number otdevices(If low vollapo) <br /> Doscrlptlon ot Wark lo�o Dono: L/�� -�'�"—`�' � — <br /> _�� <br /> FEE <br /> GITYOFEVERETTIOCAl6AlE67A%COOE1H1106 � �/� � rl <br /> � li <br /> 1 AoraDy certily Ihat 1 hnve reetl ond exominod fhis npplicefion and know(he samo fo be true ond <br /> cunocL All prnvlslons o!lews ond nrdinancos poveminp Ihls lypo of work w(11 bo complefod <br /> whetherspeclfiotl hereln or nol. The pranfing ol a pomtif does not presumo fo givn authonty fo PERMIT# <br /> violato orconcol tho provtsions of ony oUiersfofe orlceof low mgulaGng consfrucffon ortho � I �\�� _ � �I <br /> pedortnanco o(consfruction. Thaf 1 am aufhonzed by fhe ownor ollhis proPeRy fo porform tho � i � (P <br /> �rork lor�vhich opplicofion is modo and I comply wilh tho Sfafo Contrac(ors Law 18.27 RCW and <br /> <^98200 WAC. <br /> �—,. — �Z�— I� <br /> �o�,�� �o <br /> RMSE03:ri1J <br /> 7 �7 •,� !yoBL52�2hi �01 �TbT-�8L-902 ��� JI?J1J313 1JtiX3�IdOJd d92�2S ETG�2-52-�flf <br />