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i � <br /> ELECTRICAL PERMIT APPLICATIO"� I <br /> � CITY OF EVERETT PERMIT SERVICES � <br /> i <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —�^nvw everett�va.org <br /> � ���s�oa -�uy <br /> '� ....-� —I S <br /> , I 3 Z� �-�p �/-f` ��v -e <br /> PROJECTADDRESS � `�2Y ��3 -� <br /> � ���'z��-�'� f 321 I�I� �� �en�( `�� 2—O( <br /> il <br /> Orrner G7a�lAdCres; � C�y State�Z�p Phcne <br /> �� <br /> leran� �dadAedress Ciry Siate!Z�p Pnone <br /> � � � � ?ra.�7b7 ���c . <br /> i ' <br /> �,� �,ucr, � i v�� � �; ��=„�D �s-��S . �.� g �i co.�___— <br /> L-IectricalConiraetor ^ I.1a�lAddress City . Sta!e�Z�p Prece <br /> ;'1��,�� 993��Z Q,,,.o ,_ �� -�c� � z `� �`12 <br /> � S:a:e License Number(required) �— City of[verett Business License Number(required) <br /> �� �7�`/����" �f� <br /> �� I'roposed Use of Bui!d,ng Contract riP ce ef Work <br /> ��1� 7.��,. '7�,! 6�tOY., <br /> _2 S��C� ,nn� IL�G Fa L('r��-a5� Can1 <br /> li Syuare Foolage (If residential new construclion, remodel or addition) Contact Persoi��CoNact NumbedEmail <br /> INumber ofldevices (If low vollage) <br /> r I n � � <br /> I Description of Work lo �e Done: l�l.lJJ �7 ���� � '_�' <br /> � --j- '�r° --(�--D.��`�'n�-�-- — <br /> � ---- — --- --- — <br /> i FEE <br /> CITY OF EV[R[TT LOCAL SALES TAX COOE IS 3105 i��O. <br /> I !hercby cer6ly fhaf 1 have mad and r.xarrrined fhis.pplic�tion and know the same to be tnie artl _ ____ .___ ___ <br /> cormcL AH provisions o/laws and nrclinances goveming fhis type o/�vork�vrll be completed --- --- --- -- <br /> iv:hether speci�ed herein or nof. The gran6ng o/a pemii(docs nct prr:sume fo 9ive au(hority lo PCRI�111-?? <br /> �.��o/afe or cancel the provisions ol any olher sfate orlocalla�•i m�ulafing consfruc(ion or the r /� � <br /> i perinrmance ol constmclion. That I am aufhonzed by the o�vne�o(this pr�peity to pedomi ll;r E � I�D Z� V(.� <br /> I �,:ork lor�vhich application is made and I compfy k-ith Ihe State Confracfors La�v 7827 RCW and __._ ___ ___ <br /> 246200 WAC. � <br /> � �!G�%�,� �� Z � z`� " �S _ <br /> iSignature Dale <br /> ' . .... _. ..... v <br /> ., . ,..,.... <br />