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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />V � �'� �� <br />PROJECT ADDRESS <br />��Ki .. <br />Owner <br />G��;,���, v � �,�: e:1 <br />TenaM <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — W wuJ-� �'�y�'s� w.� <br />e�ti.n.� (•. e�it-�e-F� e ps G�v���t-`u ra✓v- J D✓ <br />Sr <br />Po ri�% I �j�j <br />Idail ltddress <br />Mall Address <br />EVL-l2�"Tr <br />City <br />Clly <br />�d �/ <br />� .._-a�-i s <br />�- � s�� -!�� <br />�`�'va C% L. Z � ( <br />Slate/Zip <br />Stale/Zip <br />Phane <br />Phone <br />��CDuu�r �I.�Li121L fb iiax `I°�l l�ii=�,�waN� LJ4 °Ivc%3 (yZy)QZz•z�i2 <br />Electncal Contraclor �.1all Addrcs; Ci�y staie/zip Phone <br />l�,l�.cpu�t r 3�� ��t <br />Slate License IJumber (required) ' <br />�9Pfaf�t�.�-�r�t5 <br />Proposed Use of Building <br />Square Footage (t( rCsldenlial new cons�ruction, remodel or additlon) <br />Number of devices (If low voltage) <br />��t;iy <br />City of Everetl Business license Numbcr (required) <br />�2SC� <br />Cenlract Price of Work <br />�TS G'lnMS�.�r1 T,fc'INnqKw+ryY3�vwt��u�G <br />Contact PersoNConlact Number/Email <br />Descrlpllon of 1A'ork lo Be Done� CGSM.e�L/ CJ"E�-(�'y SAV i N � ((,�-�^u'1c,�Y�(?�j- Ci� l. �LrITe� <br />F J <br />�_ `�n'n-1 Fnr+S � Rnn�i�� Ituo95 � Z �,n.�,��i �-7 � <br />CITY OF EV[R[7T LOCAL SALES TAX CODE IS 3105 <br />l hereby certily fhal I have read and exam/ned Pris applicalion and know fho same to 6e true and <br />correcL FlII provisions ol7a�vs and adinanecs goveminq (41s (ype of taork will Ge comple(ed <br />vihefherspecilied hemrn ornoL 7he gran(ing ol a permif does nol presurnc fo 9ive aulhoi/ty (o <br />violafe or cancel lhe provialnns ol any ofher s(ote orlocal /aw iegulatlnr� Cons fruc(ion or fhe <br />peKormonce o/ cons(ruc(iwr. That ! �m aufhoiized by tho owner oI fhis property fo perlorm the <br />work lor �vhich applrwtlon !s made and I compty wi(h Ihe 5(ate Conlracfors Law 18.27 RCW nnd <br />296.200 WAC. <br />OG <br />�rewscoceanuio �j� LC. 7V [:%i <br />r-ee <br />5o°J <br />PERMIT�1 <br />� I ��Z�'I � <br />