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ELECTRICAL PERMIT APPLICATION <br />--� 2 <br />i <br />PROJECT ADDRESS <br />�k�� <br />Owner <br />Tenan! <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — w,� w uJ -C �'�-r� ' 1 w4 . J�) ✓ <br />�h.ry.i ('. GJC;G`f�ieP$ � GVG+'Gf'f (�1:1—.��t+�� . <br />� <br />UNU�� <br />�� �i�F I ���� <br />ida.l Address <br />Gi41N�)V�FU,' �{�� <br />VUlci)vU,r ���?�c: <br />Eleclncal Contractor <br />��'�� ��u,.E r 3c� ��� <br />Sta�e License Number (required) <br />t'� v q,^�:i�rt�--r.�-fS <br />Proposed Use ot Building <br />A1all Adtlress <br />� <br />Y� 80 �c �I �e <br />Mall Address <br />r bll�r'T'� <br />City <br />Ciry <br />l,C� i�-t�-�N <br />City <br />Square Foolage (II residential nev+construction, remodel or addition) <br />Number af devices (Il low voltage) <br />Descnption of Work lo Be Done: �-CS�� i1L (�7�C�( y SAV I N � <br />� �5�0� `� <br />10��—,s <br />.��� ������ <br />Slate/Zip <br />Siate4ip <br />WA. `i ��oE�s <br />SlaielZip <br />Phonc <br />Phonc <br />zs` EZZ�2oi"L <br />Phone <br />,��iy <br />City o( Evere:t Dusiness License Number (required) <br />� 2�D �o <br />Coniract Pnce of Work <br />S C'Ltg,i.-(�1.J Tst'N�op.ttwtL 't--' N�.,14�+([� G <br />Con(act PcrsoNContact NumhedEmail <br />_ �.�-n� F=r�,�s , r�a,��t r�c���5 7 c�/Lc.uirS <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />/ hereby certi/y tiiaf / have read and examined fhis applicalion and /rnow (h�� same to 6e true and <br />cwmct. AIf prpvisions ollaws and ordinances goveming fhis type ol work �vill be completed <br />whelherspecified hcrein ornoL 7he granting ola permif does no! presume (o give authonty to <br />��iolate or cance! the provislons ol any oUter slate or /oca/ /aw regula�ing consfroction or fhe <br />per/ormance olconstruc(ion. That l am au(hodzed by fhe ownerol th/s proprrty fo perlomr (he <br />u�ork lo� which application is made and I compty �vifh fhe S�a(e Contrectors Law 18.27 RCW and <br />296.200 WAC. <br />r,e_�scoc.__c�< ------�I LL_ TC� L �`f� <br />l i(�r1 T S <br />FFE <br />�h 5 � �o <br />, <br />PERhiIT# <br />Ei�io-1�3 <br />