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C� <br />� <br />ELECTRYC/�L PEI�Mii A�F�LUC/!�'Y(�6� <br />CI�Y OF EVER�TT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-7.57-8810 - FAX 425-257-8857 — www.everettwa.org <br />� 3:� � r1�����-, st. <br />PROJECTADDR�SS <br />� --Ib -`��l <br />C � c� p�—t��� <br />��.� (��,s�� �, (33� ��1tiJ���, s�f !�✓c e'�JA. �(4iZ`�7 WzS-yo3-l3Z7 <br />Ownef MailAddress City State/Zip Phone <br />Tenant <br />Mail ACdress <br />[lectrical Contraclo� � hlail ACdress <br />C�ry <br />!� 5�,� �-3�3 r1� <br />SITCi:SL�s�op[� _ <br />Slale License Numbcr <br />''10M ti' <br />Proposed Use of Building <br />�.Z� <br />Squ�-e Foolage Qf residential neva conslruclion, remodel or addilion) <br />Numher of devices Qf low vollage) <br />Uescription of VJork lo Be Done: <br />c� /F)�� IZJ� 2or-ti�o <br />Zy0° 3p /�^�o <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />Gly <br />,�' C J� <br />SlalelZ�p <br />Il� i� � . �1 <br />SlatelZip <br />(. v J� <br />CoNr cl Price ef VJork <br />Phanc <br />7� �)tS��K-173�75 <br />Phone <br />Contact Person (Plan Review) <br />! hereby cert�P� that I have rcad and examined fhis application and Rnow the same fo be (rue and <br />correcL All provisions o(la�vs and ordinances goveming fhis type of work will be camplefed <br />�vhether specilied herein or noL The granting o/a permit does not preswne lo give aulhority to <br />violate orcancel the provisions o(any otherstale orlocallawregulaling conslruc(ion orfhe <br />peAormance oI construc(iun. Tha� I am aalhonzed by (he o�vner of this piopedy lo peAomi lhe <br />�.vork for which application is made and_I_comp/y with the Stafe Confracfors La�v 18.27 RCW and <br />296.200 WAC. � <br />�"G�' G����`I - <br />ZJJ Zo`� � <br />:''n �;l�l /���J <br />F[E � <br />�� i <br />PERMIT# <br />E 1 `�06-O�i <br />