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�' /. � ' ����v�i 'i� � ,.�.. .,r � ., � / " —� <br /> . . . I 2'��J_I � . . __.I��'iQ� ' �0 ��C�fn.�. �n_ <br /> r-\� <br /> ELECI�R�C��L PERMIT APPLICATIORi <br /> CITY OF EVERETT P�RMIT S�RVICES <br /> 3200 CEUAR STREE7, EVERETT, WA 98201 <br /> 425-257-8810 • FAX 425-257-8857 —�+nvw.everettwa.org <br /> i ( I 'L�l SE F�rPfP�'-'' Mol._l ��^� <br /> PROJECT ADDRESS <br /> 1�j�n��- a�' ��iC� \V1 tJ 1 �on � � C�••nr�o--�' � 1J C 'L$Z� <br /> Ownof h9ail Address City SlalolZip Phono <br /> �I �tin�� �� �r�.e� ��c �, i 1 2i�� P��rP.1-� ��\ W��1 �C�r���r 1�i✓�- <br /> ' Cily Stale/Zip Phone <br /> Tenant Pdell AdJress t . <br /> `T2.5 '���rZZ�OL <br /> \U�C'n�''l� 1"LPr�nLa/�ll�O11 �1���G1 � 'l���11_`D— IVG (NV✓�1✓�1�1�1�=c YV�'7 `�2 <br /> FlaclricalContraclor MnilAddress City StatelZip �— Phone <br /> 10�-� I�NM�. � �g ''y � � c�s.5 - <br /> Slate License Numher Coniract Prlce of Work <br /> � <br /> � �"Y�� N� �Vv1 / ��N/��1 Q. <br /> Proposed Use of Buildin� � Conlacl Person (Plan Review) <br /> � /� <br /> Square Poo�ac�e pf resid itial new conslruclion, ren�odel or addilion) <br /> � <br /> Nwnbor o(devices(I(low vollage) <br /> �escriplion o(Work to Bo Dona: ��kq�� �1 '� ��S �' � `�U[ � o�G�'��- I,J� (' � � <br /> �.� � �- 5 <br /> , <br /> FE� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � r,;� I S <br /> �r <br /> 1 horeby certify fhat 1 have read and examined Ihis applic¢i(ion and knov�the same to be true and <br /> conec�. All provisions of fews and ordinances�ovemin[/ihis type ol�•rcrk will bo comp/eted <br /> wAefRer cpecilied herein ornoL The grSnGng oI a pennit does not presume to�ive euthonty to pERMIT# <br /> violsfeorcancelfheprovisionsofanyotiiersfateorfocallawreyulafingconsfrucfionorthe �I �-\� - r 1 � <br /> pedoimence ol consWCtion. Thet 1 am su(honzed Ay Ihe ovmerof this property to pe�(omi fho 7�, V � <br /> warklor whi;h applicafion is mado and 1 comply��+if11 the Stsle Conf�setors Law 1827 RCW enU <br /> 'L96.20 'AG . <br /> �� � �i� ��-, '� <br /> i�nalura � Date . <br /> asv�c�t,aaa�i3 - <br />