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ELEC�ICAL PERMIT AP�LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 GEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �,�cvu�-� �'c; y.:' � ;�;:. ,.,� , <br />��t,.�, (•. G✓�r -�-f � �r.. <br />/ C 2�D S� EVL'-rL7�;�' duJft .? �✓ <br />J �—��-15 <br />�'�'=� ��� �.�E;€_ �..� � � so g--� � b <br />PROJECT ADDRESS <br />��� <br />Owner <br />Gi�:Il�i)'J�l �V <br />i � t�ji�F � h'-I <br />Mail Address <br />G�f r t` j. <br />Lbt1L.t'T'�- I,J•� �� � ZO � <br />N <br />City StalelZip Phone <br />Tenant � b.aail nddress Cit <br />Y StaleQip Phonc <br />{�A � � r <br />�1.�,���u�r �I,�Z7l�i(� I�U Fl�ox y��l �i 1=(L�ia,.,,, 1,.; �' c � 1 <br />Electrical Contractor � �' � �'� �� y �`!' i/ �� �l2 � Zo I 2. <br />Mail Addre-ss Cily SlalelZip Phone <br />1� <br />i��.�p«�t r_ 3�`� ��1 ��i:i�l <br />State License Number (required) City of Everelt Business License Number (required) <br />�'�c�;�ti�r��� ;,'� <br />Proposed Use ol Building � <br />Contract Price o! Work <br />Square Foolage Qf residenlial new consf« �ciion, remodel or addition) <br />� <br />Number of devices (If low vollage) <br />Description of Work to Be Uone: CDS���� 11L <br />S ��'J i N L <br />�) S . �'_ Gr i� <br />CITY OF EVEREii' LOCAL SALES TAX CODE IS 310, <br />TS C"LuS2�i.1 T;Sc'1}w9Kv.;,�2�,,vw�iNv-,4;� <br />Contact Person/Contact NurnbedEmail <br />I hereGy certi/y thaf I have read and examinee Ih�s applicatlon and know Ihc same to be true and <br />coriecf. All prow;ion; o!/aws and ordinances yoveming ;his type ol work �vill Ge comp/efed <br />whether specified heiein o� noL The qranting o/a pennif does nof presume (o give auth,ority to <br />violale vrcancel (he p�ovisrw�s ol any o7her sfate or /ocalla�v iegulating construcflon or fhe <br />pe�formance ol constiucfion. Thaf l am aufhonzeU h}� (he o�vner ol fhls property fo pedorm (he <br />�vork (or ��✓hich applicafion is made and I comply �vifh (he S(a(c Conlractors La�v Iti.27 RCW and <br />296.200 WAC. <br />i Lt,� '', � 4'��r <br />Signature � � � � T _ <br />1 �atc <br />ncvismoe;ac�ow I-L(, �TQ <br />--�---�-------.__.17 —_--�-----L��i-.� <br />L i(��-I l'C <br />F[E -- <br />� �b o0 <br />l <br />PertMn�r <br />E15Dg-��� <br />