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EL�CTRICAL pERIUIIT APPLlCATlON <br /> i CITY OF E1/ERETT I�ERMIT' SERVICES <br /> , 3200 CEDAR STkLET, EVFRETT, W.4 98201 <br /> 425-257-Q810 - FAX425-257-8857—v�n�+w.everettwa.org <br /> � � l ?>D S� C—l�-e�'� E'11c� (�r��� <br /> iPROJECT ADDRESS <br /> owner Mail address C�;yV st�romp Phcne <br /> 1�3"I ,��:N��C�`a(�r� -113D S��g�-� ` F' Q ; 1 �' �a Gn <br /> Tenant Mail.4ddrees Ciry Stnle2lp Phona <br /> ���� se� � ��,� ��a� ��.�o���D ��. r���i� �w� ���a <br /> EIBC[dC81Co�tfBetor allAtltlre;s Ciry State2lp Phono <br /> I _.nv" � Il 1 �����1 I` ��vo � � <br /> State L�cense Number Contrad Pnce of Work <br /> iQe..�{7�-i,� �.1���f-f���@ <br /> � Proposed Use of Building � :�ontact P s (plan Rovlew) <br /> �.11�,��,�n w����� �� <br /> � Squore Footage(If residential new construct�on.remodel or addition) I <br /> � g <br /> Number of devices pf iow wlNage) <br /> Descnptian of Work to Be Done: � 1� rCJ ��I ��%�/ �/l �� P ti � �f�,(/)'�, <br /> n �jnnn ' Q - n `/� ' � / �'1 <br /> I /� /Lt�%l. ('i�.ligV L�7� �J e�-���-)"N v�1�r1 � v( '/' —--'�J� <br /> ��� <br /> � FEE <br /> ' CITY OF EVERETT LOCAL SALES TAX CODE IS 310, - �-- �� <br /> I 6B�oGy ceRify that I h�vB IB�d ond 6Nfimined lhis epplicati0l)eqd knOW fhC same t0 bE trve and l j �' <br /> cortect. �tll prouisions of laws and oMinancos goveminy th/s type of trork will be canpleted <br /> wl�etl�er speclfied hereln or not. The granh)�g ol a pemiit tloes not presu,ne to give Quthorrty to PERMT# <br /> violato or cancol fhe provision�of any ofl�ersta�e orlocallaw roguleting constfuction ortire <br /> pedonnnnce ot consfructron. Tha�I arn authonzed by the ownerofthis property ro podonn the � I ;, (; � - C� �� ( <br /> ' woiit which applica(ion/s made and I comply with fhe State Cont�acfors Law 18.27 R.CW and <br /> 200 �• Ol.(r ��f'C�' - 1 ' l I � I ��. <br /> t,y1 <br /> � <br /> � � ignature ;;ato <br /> LRh'Yf�[o3���y <br />