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E�LECT�ICAL <br />PERM13' aPPLICATION <br />CITY OF EVERE7T PERNiIT SERViCES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — w w t�J -C ✓u� wQ . J�� i <br />ei..� � 1'. ���.e-+-�e�s � �ver�t�f li�a-�dJ <br />—7 � � l�c r� DEaJ <br />PROJECI'pDDRESS <br />Ovmer <br />Tenant <br />��V�1 Po ty�i� I �j`� <br />F.^,ail Address <br />Gfk:,Nov�Ew c�ir� <br />Mail Addmss <br />� i5 io -��( <br />l��al� �5 <br />� �t�u1T 1,�`,� `f � Lc� ( <br />City <br />Cily <br />Statc2ip <br />SWie(Lip <br />Phonc <br />Phone <br />iV1CDv.l.:�(� �Lc�i�T12iL Fb i>o�C i��� ��I'-(<-ta:i�.,� L.�4 `I ����'3 �yZS')EZ2 2c, i"L <br />ElectncalContiactor MallAddress Ciry StaielLp Phone <br />I��'� �����E s 3c� ���� �2� i:, y <br />State License Number (requimd) Cirj of Everetl Business Limnse Number (required) <br />i�c���rn�-�r � 3�1 � , ai <br />Proposed Use o( Building Contraq Pnce of Work <br />Square Footage (If residential new consWction, remodel or addition) <br />Number of devices Qf low ��oi�age) <br />T•i C"V�S.l�-Slhl T"St-YKo9KW�r(,�'_��.�ll,+lt�G <br />Contact PersoNContact Number/Email <br />Descnp�ion of Work to Be Done: _ ��5�'`�7�1L� ��7�(�y SA�J i N � (�-�^�:1Lf�1�'�CT�- 6}- LIGNT'S � <br />`�faTN (-�iNS � frJ"1JuL'- IC-'i�DS , J �iF2c.�f iZ <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify th2t l have read and examrned fhis application and know fhe same fo be true and <br />correct A!I provisions ol laws and ordinances goveming this type o/ work will be complefed <br />�vhetherspecificd herein ornat. The granfing o/a pe�mif docs notp�esume fo give authonty (o <br />violate orcancel the provislons o(any ofhe� s(afe orloca/!aw mgulafing consfrucUon or the <br />perfomiance ol consfrucfion. 7hat / am aufhonzed by the owne� ot lhis property to pedorm the <br />worlc Ior tahich applicafion is made end l comply with the Stafe Confractors Law 78.27 RCW and <br />296.200 VVAC. <br />FEl95En o296:ota <br />� � � Tv L(�f /� <br />FEE <br />��j�'1S <br />PERMIT# <br />E151D- I'1� <br />