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-------- � _--- --- � --- <br />ELECTRICAL PERMIT API�LiCO�TlON <br />� CITY OF EVER�tTT PERiVIIT �ERVICES <br />3200 CEDAR S-fREET, EVEkETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857—wv�v✓.everettwa.org <br />�l l g �c.a s i <br />PROJECT ADDRESS <br />t�!� 1 D F�;� I�-j`-� 7 <br />O�vner �tail Address <br />Giw1!�i)'J;E—�V V`�i I j. <br />Tenant hlail Address <br />�'Vlo��_u�r ���-n-�� P� ;��x y <br />r Lc�1°wl"7"� �,J;� <br />Ciry <br />City <br />�� i'�t�ua�..) <br />EleClrical Contractor �dail Adtlress Cily <br />t�����_��ti�e x 3C� �'-1 <br />State License Number (required) <br />��Pia��:rYl�,� <br />Praposed Use of Building <br />Square Foolage (if residential new construclion, remodel or addilion) <br />Number of devices Qf lova vol�age) <br />L.) n <br />c�2� c; i y <br />6 -�o -r S <br />� I°�06-d5'% <br />c/�Z�� <br />S�a�e/Zip <br />StatclZip <br />°�`;,cE3 <br />StalelZip <br />Phane <br />Phone <br />6"lZ-Zo i2 <br />Phone <br />City of Everetl Business Ucense Number (required) <br />� <br />Contract Price of Work <br />��C'1h3.(c-nh1 'rSi--r�w9�w2�,v..y�wu,t <br />Contact PersonlContacl NumbedEmail <br />�escnption of Wark to �e Done: CCS�c11L� iT'E'��(,y S-��Ir� i; (�„��'�✓���1'�Elv� G� ����rS � <br />� I1'Tl.� (-�� ,� ;� P.l�1 v 6l: Ftr'� )� � 7 C-c rz �y i TS -- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hcieby certi(y that 1 have read and e.eamined this application and kno�v the same to be (rue and <br />correct. �II provisions nlla�vs and ordinances 9overoinq this type of �vork ivill be complefed <br />iroliclher speci(ied heiein ornoL The granfing ol a permif does not presume fo give authoiify fo <br />vivlate orcancel the provision� of any o(her state or local laiv regula(i��y ^�mstruction or the <br />peAormance olconstruction. Thaf 1 am aufho�izeU by fhe o�vner of !nis F��perty fo perlorm the <br />�•+ork (or �ahich application is made and ! comply �vrth the Statr Confractors La�v 18.27 RCW and <br />296.200 WAC. <br />OG <br />r_viscoce.oe,zow �j���L 7Z� L-��1� <br />F[E <br />^ /� <br />� j <br />PERMIT# <br />E l S��-oS7 <br />