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ELEC�ICAL PERMIT AP�LfCATION <br />��a <br />PROJECTADDRESS <br />�: � {4 <br />Owner <br />G�::,��!`u � E��; <br />Tenant <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98209 <br />425-257-8810 - FAX 425-257-8857 — N/ cu i.rJ -2 ���v::'� =✓« - ��;J :% <br />L'lv.� � ('. �E�dre-i�eQS � �V�<'Gl'"'i ;s.'az�.9 ei ,_,; . <br />g-as�-is <br />� r 'r. � ? j;�'r.3 <br />C 150� 19 Z <br />QO hii�( I ti`I -% ��LL1Lc'TT �,•%.� c� f: Z�O ( <br />��`f � �rs. <br />Mail Address <br />Mail Address <br />Clly <br />Ciry <br />State2ip <br />Statei7lp <br />Phone <br />Phone <br />''V1.C���1.7\�� �Lt;'�.-f1'=1�. I�U l'Jx `I�61 4i-II�,f�Wl�.i� �..�q ���41ICL�S <br />� �`iZS�EZZ 2�i"C. <br />❑ec�ncal Contractor MallAddress City StatelZlp Phone <br />i��!. �:��;�.t T 3c�E ��� u2� i: � y <br />State License Number (required) City of Everett Business License Number (required) <br />�� � f� �%l1ti1.1�' l� <br />Proposed Use of Building <br />Square Footage Q( residen(ial new consiruction, remodel or addi�ion) <br />Number of devices (If low voltaye) <br />DNscrlplion of Work to Be Done: CGS�'�� 1�1LL (� <br />� <br />Coniract Price of Work <br />�S C':V.�!���tJ �;Sc�-Nw9.;w��4t.�v�,.i�iHv.,t <br />Contacf Person/Contac� NumbeUEmail <br />7 S�9'J i N � �y <br />��n�Tl�l �-nN5 � I'Nl''i�l 1Li:ti)j �`t, '�c•fi%l <br />CITY OF EVEREi7 LOCAL SALES TAX CODE IS 3705 <br />I hcrehy certi(y thaf I have read and examined (hi; applica(lon and know (he same (o be (ruc and <br />coriecL All piovisions olla�v; ard ordinances governing this type ol �vork �vill be comNleled <br />evhether speci7ied herein or noL Thc granling oI o permif docs nof presume (o give aufhority lo <br />violafe or cancel fhe p�ovisions o1 any ofher sta(e o� /oca/ law iegulafing consfruction or (he <br />peAorrnance olconsliuction. Thaf I am au7horized by (he owne� ol Ihis property to perlorm (he <br />work /or w.hich applfcation i; rnatic and l comply wifh (hc S(a(c Con(�actors Law 18.27 RCW and <br />296.200 WFlC. <br />erviseooaincn.oia _ ___ �j! C.L__ 7�) [� �'"f� <br />G L i(;� i7'C� <br />rec <br />�� � <br />PERMITtf <br />EIS�B-1�12 <br />