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� <br />ELECTRICAL <br />- — � <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — W w uJ -� ✓��`'`f wd. - Jd ✓ <br />e i.,, � 1• � o v rc �+�f t p s� e v���t9' td:.z ..q d✓ <br />J <br />8�I LINDF� <br />PRO.;ECT ADDRESS <br />tF(b1 P� �i�F I �j�17 <br />Owner Mail qddre;s <br />G�,�;,,�",����L c:�;�s. <br />Tenant P1ail Adtlress <br />I'��U6:L:��^.. �1c2'Tl'-�L FG ;vF 'i��( <br />Eledncal Contractor Mail Address <br />1�'��'' �Du�E � 3�'"6 ��t <br />Slate License Number (required) <br />I��f� ��fili���"i S <br />Proposed Use ol Buitding <br />E�r"1L�'i� I..•a, <br />City <br />City <br />�i P--(LvraN) <br />City <br />Square Poolage Qf residential new consiruction, remodel or addqion) <br />Number af devices pf lo:� vollage) <br />6/S/o—�� <br />lo -i�--15 <br />cl � � �' <br />S�ate/Zip <br />Slate/Zip <br />1�J�, °I �'DE'3 <br />Slalc2ip <br />��2Y i; � y <br />Phone <br />Phone <br />Zi)�l2-lo�Z <br />Phone <br />City o( Everetl Business License Number (required) <br />� Z50,�% <br />Contra;.t Price o( Work <br />TS-G'�,u3.lLllnl TSc -Yxo9.;w �� �v,.r �i�;�, � <br />Contact Person/Contact NumbedEmail <br />Descnption of Work to Be Done ��LSM` il L� (���C{�{,y 5 Av 1 N � ^^ <br />�.tl ;�..:.(1MCNj- G� lii�N7"S � <br />��'r�1 FnrS � i�1�uc K�c)S► % U2c�„i TS <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hemby ceRr/y fhaf I have rcad and axamined fhis vpphcation and know fhe same fo be froe and <br />cormeL All provrsions o!laws and ordinances governing Ihis typ^ ol work will ba� cnmp/eted <br />�vhether specified herein orno[ 7he grantrng ol a pr.rmit does not presume to give authontylo <br />vio/afe or cancel the provisions ol any other sfate o�locaf !aw mgulating construcGon or the <br />perlormance o/consfruclron. That I am aulhonzed by Ihe owner ol fhis prcperty lo peAorm tbe <br />:vork lor which appliw(ion Is made and I comply witn fhe S(afe Confracrors Law 18.27 RCW and <br />296.200 WAC. <br />r.�. .cn ,. :_�: � r L C -ll L� i/� <br />FEE <br />�'Sa,� <br />r�ear�rru <br />E ��10' D�� <br />