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A25-252-1666 CMHEATING 12 20.00pm. 06-18-2015 6/7 <br /> ... ___.........__.._......_ __ ____........__._._...•..______.—__—_________—' ___'___ ' _.. __._'_ '. . .' _ ___-_.__. <br /> ELECTRICAL pERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREI`f, 1NA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> � �So6-�3z <br /> � -� S�-is <br /> .��zl 1.omE�ard it�.�� U".�t b <br /> PROJECTADDRESS <br /> �av i d l�v_�_5�� Ll25 Z119 Ki8/ <br /> OWrte� �dall Address <br /> Clly Stale2lP Phanu <br /> Tenaqt � . � . . Mall Addre:, � C�ly . <br /> . Stala2ip Phono <br /> crn �r�}inG ( v�c. I�15 grcedu�c�u E�i,er�etf-. WR 9g�o� i�z5 2�9 �1��� <br /> � ncaiuontraC� h,oilAddre9s � Clry � StaIeJZJp Phonc <br /> I <br /> � <br /> Cm I-�M�}g'l7 D►� o i (v og R <br /> Stale Ucerlse N�mber(reqDired) . . � Cfty of Eyerett Business Ucense Numbor(requlred) <br /> Z�o _-. . <br /> �ropased Uso of Building � � - � Conlracl pdce of Work <br /> Squaro Foolape(If rosldenlial new consWctlon, romodel or addilion �`�"` �ZS zS 1 ��5� <br /> � � ) �ontacl PersoNConlact Number/Emall <br /> Numhor o(devicos Qf low voilagc) . . <br /> Doscr(pllon of Work�o Bo Done: ���,u (y{yG��s �,�W'� ,�[�j'�� <br /> F[E � <br /> CITY OF EVERCT7 LOCAL Si1L[S TAX COOE IS 3105 <br /> I homGy corti(y fha(I havo mnd ond cxnrnincd fhis applicaljon and knoW(ha samo fo bo lruo and � O� <br /> ' carmcf. llll provisfons ollo�vs and ordinances govaminr�thls lypo o(war��wlll bo campfafed <br /> wholhorspod�ad hoicln ornoL Tho rjrantin9 0l a pormit docs nof prusumo to glvo aulhority(o pERM7i'# <br /> vfolafa or cancc/!ho pmvis/ons o(any olhcrs(afo orlocnl law re�ulaling consfnicfiod or fho� <br /> podormonco o/cpnsfnic(ion. Thaf f am aulhor�zod by(bo o�yn�r o(fh/s prop;�Ay ta pedarm(hc E� 5o�j� "I J 2, <br /> ivodr/or ivhlch app/icdlion!s mado nnJ 1 comply w(�h fhe�5(a(o Cnrilraclors Laiv 98.27 RCW and ��� <br /> 29Cr.2b0 W/7C. ' � � � . . <br /> . <br /> l k�:�-p� 1�aa,�R.�(' Lo-f S•f�J <br /> � Slgnalurp/ � Oato <br /> U <br /> RLYISE➢03OGpp�J . <br />