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� � <br />ELECTRICAL PERMIT APPLICATION <br />� z-z <br />PROJEC7 ADDRESS <br />��b <br />Owner <br />Gi2vl l`��) � : �IAi <br />Tenant <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — u1 w vJ _� i�as��=�-; w.�t . kd ✓ <br />en.�.� l•. ��ere-f-fePs � dvi,�Gt�` :r�ct, JOJ J <br />�., a0 -� S <br />����s- �-,50�.-�� 3 <br />i'u 8`% I �J`I? <br />Idail nddress <br />Idall Address <br />Cvr-n,�'r� <br />Clly <br />Clly <br />i , � �� <br />l.�ac �% � ZO � <br />Stale2lp <br />Sta(c/Zip <br />Phone <br />P�ane <br />��CU�tu�,2 �I,�Z�IZiC: (�b 8oj� i$�� I�C���t.r_i�.,� l,Jp, I�UC�i3 ���zi)EZ2-lo�Z <br />ElectricalConiractor Ma1lAddress Ci1y . Slale/Zip Phon^ <br />�'J•_;:�u�E x 30� ��t <br />Slate License Number (required) <br />��Gra(t�'t�� <br />Proposed Use of Ouiltling <br />�vc:iy <br />Cdy o( Everelt Ousiness License Numbcr (reyuired) <br />� 25C� <br />Contract Price of Work <br />� TS G"tn?IlLtlnJ 'f;it-W.o9ww2ti��vw�iNu�� <br />Square �oolage Q( residential new consfruclion, remodel or addition) Conlacl Person/Contact NumbedEmail <br />Number of dev' (If low vollage) --, <br />�escriplion of Work lo Be Done: ___�•�Sn"`"'�1L/ C-��C'(�1,Y SAV7r' � lir-�"c.:1(.d�1M/-n+t- .:r '�:/...�-r'?' . <br />_ � `(i !�"('1� �n N S � 2t1 nl l+l f{:io 9$ �,. C.� iz� i��. <br />r <br />CITY OF EVERF_lT LOCAL SALES TAX COOE IS 3105 <br />! hereby certrli � fh�t I have read and examined (f�is applica(lon and knovi fhc same !o be true and <br />correcf. All r�ovisions o! laws and ordinances goveming this (ype ol v.�ork ivlll be compleled <br />whefhe� spec•iliod heicin ornoG The gran(Inq of a permif does not prosume !o give aufhor/ty fo <br />violale orcance/ the provisionr o/any o(her sfa�e orlocal /aw iegulating const�uction o� the <br />peAormance o/ consf�uc(ioit Thal 1 am aufhonzed Gy fhe owner ol (hie propedy (o perlorm the <br />work /or whlch applir.alion !s made and l compty wi(h (he Sfa(e Confracfors Law 1827 RCW ond <br />296.200 WAC. <br />OG <br />nEmsrncem�.om �jt�GL 7j� L��{� <br />FEE <br />5� 0� <br />PERMITJt <br />E��507-I13 <br />