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ELEC�ICAL PERM�TAP�LICATION <br />�3 I Z <br />PROJECT ADDRESS <br />t Fi Fa _ <br />Owner <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAk. STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — W iv uJ -z �'�Ye."': ��2. •�� +/ <br />e a,� � I'. L JrL r. -F-�.e p 5� e verLt=y� :,v�- •�,� J <br />J <br />��� <br />L ��so6-�( <br />6 -�-6-r 5 <br />Cs�:u���viEw i�1 <br />Tenan! <br />ro y� j� I �j�j � <br />Mail Address <br />Mail Atltlress <br />E�VC'?l,,:'Tr <br />City <br />City <br />C� Yi Z-D � <br />StatelZlp <br />State/Zip <br />Phone <br />Phone <br />����.C�v l.o�; �I,rZ'�12iL f'� �;a jc y��� l;Ci i°—c�i.va�.,� LJA. I�i1D ti 3 (yZi ) 822-2c i 2 <br />ElectriCal Contraclor Mail Address Ci(y State/Zip P�one <br />��'u'�� ��u�� � 3�� ��i ��;�. i:� y <br />State License Number (required) City of Everetl Business License Number (required) <br />I�Pta(�%n'11.�,�f5 <br />Proposed Use of Bwlding <br />Square Footage (If residenlial new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description oi Work to Be Done: (•CSM�'�"j <br />� <br />Contract Price of Work <br />TG-w�ruiN rsr-na���n.� ��w�,�u,� <br />Contacl Person/Contact NumbedEmail <br />SNViN� <br />�+�•r�i Fn,� s� �i a �c t���� ) s Z c,� ✓�c.H � rs <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />1 hereby certily fhat I have read and examined fhis applicafion and know fhe same fo be true and <br />correct. All provisions o/laws and ordinances qoverning this type ol work wil/ be comoleted <br />whether specf�ed herein or not. The granting o/ a permit does not presume to give aufhority fo <br />violate o� cance/ fhe provlslons oI any other sfate or local law �egulating consfrucfion or fhe <br />performance o/construction. That ! am authorized 6y the owner o/ this property fo peAo�m the <br />work /or which application is made and I comply with �he Sfate Confracfors Law 18.27 RCW and <br />296.200 tNAC. <br />RFVISEOOb96Q0f4 ���`L .-.�\ ���L <br />I V '7 <br />'� L.i(�i-7T'c� . <br />FEE <br />�50 �'- <br />� <br />PERMIT# <br />E 150�-201 <br />