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� � <br /> � ELECTRICAL PERMIT APPLICATION <br /> riTY OF EVERE i T PERMIT SERVICES , <br /> 3200 CEDAR STREFT, EVERETT, WA 98201 <br /> i 425257-8810 - FAX 425-257-8857—w�w�everettwa.org <br /> I� I <br /> i31 � "�ou�sz_v � ��r� Zoo 9�'3203 <br /> PROJECT ADDRESS <br /> ' 1�C:T Ti.LLJSTR-IP�- ___ —--_ � <br /> Owner �da�inedmss Cry Slate2�p Pho��e � <br /> ��Y i�zoDu��rs 1310 �NDUST'2Y ST S��r� Zcn F�r�rr 98203 `l'LS 551 iz� <br /> Ter.ani �.1ad Atltlress C.ty Stale2�p P�one <br /> I �-�a,,�.t?iDh� Fchc_-r2« 1�29 181� P� S�c/-- l�tuuvtoa� V.�a 9��'1 'f-2577r379r(o I <br /> ' FeCt'�[<ll ConlraCtor 1"ad Addres; Ctly Slale�7ip Phonc � <br /> I�/+MI�T—e.L OS'l-R1 �43��lt� I <br /> S�ate l�cense NumCe�(reqwred) Gty of Everett �usiness License Number(requ�real <br /> ' 'Ti�It�JJi"f121A1- ���: JrOl7 ----_-- <br /> Proposed Use of�w:dmg Cant�act P��ce o(Work <br /> t'�A�EI t+�MPrDnI 20c. �Z3 �52<� <br /> I �GVGY�—�LGrVI.C�WI • COM �. <br /> I'� Square Feotage Qf resitleMial new construction, remodel or adtlAion) Contact PersonrContact NumhedEmad �I <br /> li ��umber ol devices(II low voltage) <br /> � Descriplion of Work to �e Done SfvSrRi.t. �.1cV.! �,�lASL�F-]-ouSTc 1-E I '3AY rlxT+-�R-fc S _. <br /> I <br /> ' -- ---- -._. . . I <br /> FEE ' <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS J105 � �f'�Z .�O I <br /> �� I <br /> l hereby certdy fhat I havc read and e.+amineU Ih�s app6ca6on anA know fhe same fo be Vue and ____ .. ___ . __ _ 1 � <br /> conect A�l provrs�ons of la�vs and ordinances gcvemmg Ifus type n/�t�ork wrlf be complefed �------- -- -- -- � <br /> I ��hefher SpecJietl he�ein o�nof The gran6ng oI a permd does nof piesume lo grve authonty fo PERMITN � <br /> �i vrolafe or cancel U�e prov�sions o!any ofher stale or local law regWaGng conslrucfion or(he � <br /> I peAormance o/conslruchon Thaf 1 am aufhonaed by the owne�ol fh�s propeRy fo peAorm Ihe E I(�O 3' I � I <br /> i �vork lor�vhich app6ca(�on rs mada and I comply wdh 1he Sfate Contracfors La�v 18 27 RCW and <br /> 296 200 WAC <br /> �J� , 3 •3i � i� <br /> Signalure Date <br /> PqqSEOCA.i20�a � <br />