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� <br />ELEC1'RICAL PERMIT APPLlCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, E`JERETT <br />425-257-8810 - FAX 425-257-8857 — <br />Ck.p.� i'. LJL�c+i.�PS � �✓�i'G'�'� <br />,. <br />Li � V L � U,. 5 i <br />PROJECT ADDRESS <br />� �'r1 <br />Owner <br />Cy w� i� �) U s Cw� <br />Tenant <br />Po �i�j I �j�j <br />Mail Atltlress <br />Mail AUtlress <br />C vr�lu� <br />Ciiy <br />Clly <br />, WA 98201 <br />w/ w uJ -� ��ar�-�{ wct •�+� ✓ <br />G�;2- • .� d � . <br />J %--�—/S <br />� �s6� -- aiz <br />��a � y% LJ ( <br />Stafe/Zfp <br />Stale/Zip <br />Phone <br />Phcne <br />tMCu�i.ar ��c�-'nZiL �a LaX yu�( l��t'-(�i.�a�.,� LJr�. °I�'e��y (`!Zs)E2z•zoiZ <br />[leclncal Conlracfor Mall Adtlress Ci; <br />Y SlalelZlp Phone <br />I!'J`_�Dti�t x 3e� ��1 <br />State License Number (required) <br />i�c;�r�1� ,, �� <br />Proposed Use of �wlding <br />Square Foolage Q( residential new conslruclion, mmodel or addilion) <br />Number of devices pf low vollage) <br />o�c;iy <br />Clty af Everett Business License Numbcr (reqWred) <br />� 2GJ�,�� <br />Contract Price of'Nork <br />1.1 �.`iM1�iLTjh� T.{G'1'�W�'�11W�b'� NWII�IL�I <br />Conlacl PersonlContac! NumbedEmail <br />Descriplion ot Work to Be Done: �.cS�K�1L� FI�C�j(,`/ S�A'v f i� � ll,c �°u�LEV� E7�i- CSr= ��G�i rs <br />i <br />_��'nt r-nNs � ,z,�,.,�� �1���>s Z �.,.:..�,n _. <br />CITY OF EVERETT LOCAL SALES TAX C06[ IS 3105 <br />I hercGy certdy Uiaf I have read and �xamrnod llris app/icalion and knov� fhe same (o he frue and <br />coriecf. All provisions ol laws and oidlnances goveminr� Ihis type oI work viiU be completed <br />whethe� specilicd heiein ornoL The granting ol a pc�mif does naf presume ro give aufhority fo <br />violate or cencel the piov/slons oI any oNier sfa�e or /ocal l��v regWa(ing cons(iuctlon or fhe <br />pedormance o( construc(ion. That l am aulhorized Gy the o�vner ol fhis praperty fo peilorm the <br />work for which applical/on Is madc and l r.omply wilh fhc Sfa(c Cont�acfors Law 10.27 RCW and <br />295200 WAC. <br />OG <br />n;vismamcccor� _.. �jf LL 7V <br />FE[ <br />�G�Do �i � <br />PERMIT# <br />El�b1-2I2 <br />