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�LECTRICAL PERNIIT A�PLICAilOi� <br />CI7Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEP.CTT, WA 98201 <br />425-257-8810 - FF�X425-257-8857- u,'w��J-C�'��.;'``=�.2.J.•,�;. <br />✓h��i��' LJd/G'�'f��7'�-'_��GVtfLf�leJ2��j�+�% <br />.J ��s � � '� o � <br />��� <br />PROJECT ADDRESS <br />i <br />i 0'�vner <br />i <br />.vvt <br />� �i 1�1 <br />L-t r, ����� <br />Po ���i' � h`i % <br />1."a:l �Cdrtss <br />r <br />Li(.:i:'�����,���.� ;:�Iri <br />MaP Atldress <br />[ �-�����T. <br />Cnv <br />Clty <br />li-i2--iS <br />� v, �r �' =�' � <br />5'd:B/[:p <br />Sfal[l2ip <br />P'i�re <br />Pnone <br />, <br />! IvI,^,D.:u:�= �LZ'(i'-�L t't ;ioc yq�� �ti,PaL.a,�9 6JU. `��i.'�'��> �y?S"�c?L ZoiZ. i <br />G'ee!ocalContraclor L�allAddress Cit� StateiZ�p Phona � <br />�1 <br />' 1'•� �p�;�r Z �i`C� i,�1 ���,�.���� <br />';'ale Ucer;e Numter !rrqwred) Gty of Evere!� Susiness Licenso Number (recuired) � <br />;JCta���'�iT;�i: �,{��,{),{�p �__ ��.�% <br />' ��roposetl Use c� 5u�ldine �^�� Con!rac' P�iCe Ot Wo;k ' <br />A <br />�puare Feaiage Q( residentlat nen, consiructioc, remodel or addilion) <br />� <br />tiumber of devices Qf tow voYage) <br />��W.Ii'<-S1rJ iSu�-W.oO�;wit��+i ,�,,.,�i,+u� .�� <br />Contac� Fersor��Conlact Number/Email ' <br />Gescdpllon of Work to Be Done: CC.S�"��l-IL/ C�?�cfi'��. Y S,a'" ��' � i�,�"1 ������tl'.�livr �.�- t��C�� ��S � ! <br />v11�I'L� 1-n,-��i � 141rvi:l h�'�')S � �tlZr-a.11'1�C �I <br />� <br />i <br />FEE <br />CITY OF EVER[7"T L6CAL SALES TAX COOE IS 3705 ��� <br />i!�e,vby corf,ly that 1 Peve read ar,d examinedl�Is appl,ca;;a: ano kru�}• the ;a ,ne to be true anc � / <br />, c�nect. Rllprovrsions o/lai:�: and adinances govem�ng tnis ;yp= ol �sorK �vlll oe comple(ed <br />i •,�heLhc�specified hercin ornot The granfing ol a permit do^s nof pms�me (o give authcr'ty to PER��1ITt: <br />�:::;l�te or carrce; tho F�cvi�rcns of ony other sfa(e or �ecal la�v �e9�datmg consfn,clion er fhe r � <br />i periormance o/ construct�o,� Thaf I arn aut,�o�ized by Ihe owne�ol fhis propcKy (o perloim (he E I 1� I I U <br />i�v�rX for which applicotim, is maae and I comply ivi(h (he S�afe Convac!as Law f 8.27 RCW anc � J <br />, 296200 VJAC. <br />-�: _ . <br />:.:, ..`..�.:., -, _ . , . <br />--- - - � . _ --- ---- G i � C, ' u i_ r-t / I <br />