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^lor 22 13 12 28p TSI/Nlelro Link Secunty <br />. <br />1-866-40'L-7578 0 1 <br />• <br />ELECTRICAL PERMIT APPLICATION <br />�ITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, VVA 98201 <br />425-257-8810 - FAX425-257-F3857—www.evere�va.org <br />0 <br />O l t S. E. t.,/E��'�� Nt� 1�.:�-`� <br />PROJECT ADORESS <br />1 ��l.w� `"Cfee c°� tl S E. EJe,re�t v��� (.��+�E:�e�-CJi9 5'�ao8 <br />Owner Ma�l/WcLess City S�❑u+2ip �Pr+onc <br />C yas 3Ys-s9v;- <br />�\G _M •Q- � � <br />Tenant <br />clecirical Contraclor <br />N.ail ACCn:ss <br />9iy l�Yf`' <br />Mail Addross <br />c�'jE7'r�oLS 9yoGF <br />Sl,�te Licorse Numbar <br />�Q �a: l <br />Fropased Use of Building <br />Clry <br />�'l5o U�l: <br />�bo 0 <br />Square FootSge (I( residentlal new conSWction, remodel or addition) <br />C� <br />Numbcr of devicos (If low voltage) <br />Descnption of Wark to Be Done: �QCw /� it�� ^ <br />C�TY OF EVERETT LOCAL SALES TN( GODE IS 3105 <br />City <br />Ste.�. <br />Stata2�p ?hrnc <br />�J( lnl!'-1 a6or2�- <br />StalolZip Phone <br />d� o � <br />�E (� <br />p0o <br />Coniract Price ef Work <br />�b er�- e�:-�.�� S <br />CanL�ct Per�on (Plan Review) <br />�'2.o�'��i•�o�f0� <br />I hemby coRil}� that 1 hove mad and examinod (his opplicufion and know fhe same fo be (rue and <br />correct. Alf pravisions oflnws and orr/inancos goveming this type of work will be complofed <br />v�helher specif,oJ herein or no1. The qranting a! a permit daos not prosunt? to givo authonty to <br />v;da(o or cancel fhe provisions olany ofhersfafe o�/oca/law regulafing conslroctlon orfhe <br />peAonnance o(construction. Thaf I am avthonzed by fho owner o/this p�nporty lo puAorm the <br />work (or which appJiwfior, is made and ! canply with the Sfate Contraclors Caw 78.27 RCW and <br />2962001h�AC. � /— <br />I REWSED L:Srt7 <br />��� ��� <br />�C`� <br />�- <br />,�1�� � <br />C� �- Yoa- <br />!/..� 3� ' � 3 <br />�d <br />FEE <br />�C� - V— <br />J <br />PERMTi� <br />E9��I-1�o <br />- 33 9- G %o � <br />