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l� <br />u <br />ELECTRICAL PERMIT APPLICATION <br />� 7,e <br />PROJECT ADDRESS <br />� � H� .. <br />Owner <br />GViiANQ �'i �Vti <br />Tenant <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — ta/ w uJ -� ✓trG�`-` W� •�v t/ <br />l� <br />e�t.a� I'. eJ��6-i�IC�S � �VV���t� �u- JoJ . <br />% " �.d �� j <br />� �., 5 � � /,5b`7�- �// <br />P° b`� I �7`17 <br />Mail Address <br />Molillddre;5 <br />E�c-ti;,�'r� <br />City <br />Clty <br />L-�> � `% � Za I <br />SlafclZip . <br />Sta(e/Zlp <br />Phonc <br />Phone <br />�UICu��.u�r �t.�Z'tY'-iL Pb 6ojc `{��l �;!ii'aht�rar,� I�Ja, I�e$3 (�iZS)87,z�zoiZ. <br />ElectricalConlractor MailAdtlress City Slale/Zip Phone <br />��,,�,.�pu�E z 3oS ��1 <br />State Ucense Num6er(required) <br />��Jvr�ra�rt�.�r.r,s <br />Proposed Use ol Building <br />Square Footage Qf resldenllal new construdion, remodel or additlon) <br />Number of devices (I( low voltage) <br />�2�1;�y <br />Cily of Everelt �usfnesc License Number (requlred) <br />� 250 <br />Contracl Price o! Work <br />l -� G'�U21LSlh1 %Sb'INo9.��nrt,� �vw �i�k��C <br />Contacl Person/Contacl Number/Email <br />Descrlpllon of Work to Be Donc� CCS��i�1L/ El� �C�,`j S�RV i rri: (�p1^uqL�1MET"j- C�� 6�1G�7-� � <br />� T��'T�N (-In N 5 � R!'1 nl Vl-`� f f�o 9$ � Zj �n �2�:.� � r; <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3705 <br />I hemby certi/ylhaf I have road and examined this appllca(ion and know fhe same (o be true and <br />correct. Al/ p�oNsions o/farvs and ordinances goveming this fype of �awk wi!lbe comple(ed <br />rfiether speci/icd horein or no1. The yranfing ol a permit dnes not presumo fo givc ou�hority to <br />violafe or cancel the provlsions of ony ofhor s��te or local /aw regWafing consfructlon oi Nie <br />per7ormance o/ cons(iuclion. Tha( ! am aulhorizetl Gy fhe owner a!(his property fo per/orm the <br />ivoik lor which appliw(lon Is made and 1 comply �vi(h Ihe Sta(e Confractors Law 1827 RCIN and <br />296.200 W!1 C. <br />nwrscoour�F-ura �jl�L(, "� <br />f=EE <br />50 °�' <br />PFRMIT# <br />Ei507 - �� ( <br />