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ELEC�ICAL PERMIT AP�ICATIOM <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, V�IA 98201 <br />425-257-8810 - FAX 425-257-8857 — u/ c:� �.rJ -z ��-✓�"�' :��.. J J✓ <br />e it�.,�; 1�_ �✓�r��F-�� ys �� ev�r�f-�� :��-� o v <br />C1�06-0`%�l <br />Zi� ���.«r ��--�s-i5 <br />PROJECT ADDRESS <br />��V�'1 Y'D rj:� I �j'-�7 <br />Owner M11ail Address <br />i <br />--�uiw�)J�EvJ p;�;,.� , <br />;. <br />Tenanl tdaii adtlress <br />��U�i)�',�;��"- ��GZ-i121L <br />Electrical Contrector <br />j�'`I.cp��lt z 3l`6 <br />License Number (required) <br />�JFI� �..Tl l't.ri� l � <br />Proposed Use of Building <br />E�c"l:,c'TT j,J;� `� � Zc� I <br />City <br />City <br />Slatc/Zip <br />StalelZip <br />Phone <br />Phone <br />i!.� 13o n ti°�( l�� i=t�-�.,a��� ��. `I v C ti� 3(y Z; ) E'l2 2c i 2 <br />i�."ai� Fddress Cily Statc/Zip Phon? <br />p2:���y <br />Ciry of Everett Business License Number (required) <br />ootage (If residential r.ew construc(ion, remodel or addition) <br />� <br />Number of devices (If lov: vol�age) <br />l� <br />CoNract Price of Work <br />"j`S 6-�n�.�zqn� rsc-�xu�.i�..;�a�.n�,�u�v,� <br />Contact Person/ContaU IJumher/Email <br />Description of Work to [3e Done: �'=,5�`",1G/ L��(�,(�7 5•�'v IN l fLc"���:.���)��e7vj- t�}= � tirl7"c. / <br />k <br />� `�il\"Il.� i-P\�S� 14�:Jiol N-4i)j �jLI1Z.Gj17-� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />1 hereGy certily tha! l have read and examined this application and kno�v Uie same to be t�ue and <br />correcf. All provisions olla�vs and ordinances goveming this type oI �:rork �:ill be completed <br />�•ihether specitied heiein or noL The granfing of a permit does nof p�esume lo give authorrty fo <br />violafe or cancel the provisions ol any olher sfafe or local law regula(ing construction or the <br />peAormanre o/consfruction. That 1 am authoiizetl by fhe o�vner o( this property lo peAorm the <br />�vork lor which application is made and I comply �vith (he S�afe Conlracfors Larv 1827 R�W and <br />296.200 WAC. <br />�( <br />aevrsenoemen.mo �j��LL --� L�'t <br />F-[E <br />�� 5' °� � <br />. <br />PERh1i i?r <br />E I � D(�- ��j� <br />