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� � <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EV�RETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE7T, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - iv/ ai vJ-C �'Grc`!�' uG2 • y/7 ✓ <br />�l�na� I'. tJrLre-Ff�vS � dV�rG%U� �W�-.y,�".I . <br />- �J � .� �-a — � � <br />� � 7 i,��.� 5� <br />PROJECT ADDRE55 <br />��w _ <br />Owner <br />n° n'i i 5`1� E <br />G��:,����v�Ew c:�r�- <br />lAail Addres; <br />City <br />G� �So��l�c/ <br />i�--r. % L Z� f . <br />'- - <br />, <br />Phone <br />Tenant � tdailAdUress , Ciry 'StalGZip Phone <br />� <br />��ICDUU�f �(.cZ�l�lC, Po %�aj� `{v°�� l�i�'-�Lwa��) �,Jn,/ `1 �"UC�13 i`!LS')EtZ-Zu�2 <br />EleclricalConfractor MailAdtlress Cily �� Sta�e/Lip Phone <br />lnJ`•.�pH�E x 3�$ l./1 i' a?r"(;I `i <br />Stale License NumUer (required) � <br />�J%f�R/iltilkl�� � . � � <br />Proposed Use of Duilding % <br />Square Footagc (If residential new construclion, remodel or addition) <br />Number of devlces Qf lovi voltage) <br />Descrlplion of Work to �c Done: <br />� �.A'RI FnNS � <br />i�l <br />FJc � $ z �-� �a,,,� � <br />\ <br />� <br />GITY OF EVEREiT LOCAL SA�ES TAX CODE IS 3105 <br />City of Everell Bu;iness Licensc Number (required) <br />�.-Z50 <br />Contract Pdce of Work <br />Contact <br />1 hcmLy certily Ihaf I have icad and exarnined thls epplica(ion and know Ihc samc lo bc true and <br />wrrecL All piovisions o/la�vs and ordlnances goveming this type olwork ivil! 6e comple(ed <br />�vhetherspecilied hercin ornoL The g�antinq of a permi( does not p�esume fo giva auUiority fo <br />violofe orcance! the provlslnns olany o0ier state orlowllaw regvlatL�y cons(ruc(ion or (he <br />pefformance o! consfrucfiorr. Thof l am authoiketl6y fhe oronero/fhi: p�oporty to per/omr (he <br />Iv0/k IOf N'hich applieaflon !s made and i comp/y wifh thc Sfatc Con(racfor, Law 78.27 RCW and <br />29& 200 WAC. <br />06 <br />ncroseu oam,co ir <br />-- —� � L L � L (-1 /i <br />W+2�L' N.Jll,•ilC� <br />� �G�+-r ", <br />�SD� <br />PERMITt: <br />E 1507- L � � <br />