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� - -- - - - --�- - <br />� <br />ELECTRICAL PERMIT AF'P�IGATION <br />� CITY OF EVERETT PERMIT SERVICES <br />, 320� CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8�57 - wv✓�v everett�va org <br />APPLICATIO�IS ARE ACCEPTED FROM 8 AM TO 4 PM <br />gl� �/�y7, <br />PROJECT ADDRESS <br />� <br />�� ��G �%�n,t[z � mP I\ObeT'IS 6 �Z �l�y� �UG �vcr�� t,�JN' 9�� � .�� <br />O��mer 7dailACdress C�y StatelZ�o Phore ��. <br />yL5-2lo-oe�{Z <br />� <br />Tenant <br />Mad Address <br />i...le�e�y�..� �ic�•-I-r.� N4/y (��,�.ad ir�e <br />Electn:alContractor L1adACdr=ss <br />L�E��E� 9190�,✓ <br />Stale License Fl�mber <br />�We��iN9 � Sniyle Fwi«•�y <br />P�oposed Use o( �wld�ng <br />Square Foot �c�e (� �idenlial new construction, remodel or adddlon) <br />City <br />Stale2�p <br />Pnone <br />�✓�Ie� � p� 9 �w3 �LS -7YD-3/�� <br />C�ly Sta!e2ip Ph.cne <br />Uescrip�ion af Wark ta Be Done: �-v^"'"""� "`��J ,_ �'`"�` <br />—�5�.�� <br />Conlracl Pnce of V`Jork <br />Contacl Person (P!an Review) <br />A �Oi L:o.iM.- Q�NDrv- IzC W°t4oI.S..' <br />-----. _..-- - -- <br />�{�"x�c, ?ess. s�i � -- '�. .t, <br />� �A -.. � --�"'"A � _ ,t,, b �.�+e�r�- . � e�...e�,- _> s,,.. K.r.o4 �- '�eu� � . ��'I <br />S �,,,o.�.. �.,�- `"� �.�,,Gl. `-� �' �"� s' �' , -- .– _--- <br />-- — -- � <br />NOTE WIRING IN NON-DWGLLINGS I� REQUIRED TO <br />BE IN RACEWAYS, ���C OR AC CaBLE. <br />GTY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />1 hereby ce�t�ly fhat I have read and e.amined this applicat�on and knovi Ihe same fo be (nie and <br />conect. All prnvisions olla�vs and ordinances governmg Ihis fype ol work rvill be completed <br />�vhcfher speci6eA herem ornot. The g�anting o/ a pemn( does nof presume fo give aulhunly fo <br />violate or cancel the provisions ol ony other s(afe or locaf la�v ie9ulafing conslnicfion or fhe <br />pedomrance o/ consfn�cfion. That I am aufhonzed by fhe ov.nerol fhis�,one�ry ro �e�o„�, u,e <br />wo�k for which appl;cat�on rs m��de and I comply �vifh the S(a(e Confrac ors La�v 78.27 RCW and <br />296 200 WAC. <br />� <br />/ti� IS/Zoiv <br />FEE <br />7s °� <br />�1Z�D- lol <br />! N,��� <br />�;s.sw <br />tx`. Fl <br />y,.»!w, <br />. "_`_.._....� ^� v _'_" <br />