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� � <br />ELECi'RICAL PERMIT APPLICATION <br />C1TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98209 <br />425-257-8810 - FAX 425-257-6857 - W w uJ-� ��zr��;' iJ�+ • 4v i/ <br />ert.�ti� (�. ��er��F�ej�s G ever�t-� �d_•��9d �. <br />�J <br />� � � 'Lc� (.���,— <br />PROJECT ADDRESS <br />�.�� . �D.�.` �.y`'� <br />Ovmer I�1ail Address <br />Grw,����u;�� c:1� � <br />Tenant <br />'�VU;VLtIi\(= �I,CZ�IZIC. <br />Mall Address <br />Po � o X <br />tieclricalContraclor b1allAtltlress <br />1�,1•.�pu�Ei 3�� i,�1 <br />5(afe Llcense �'umber (required) <br />��JP�ar�1�.�r.res <br />Propcsed Use of Building <br />e vi=�t,�'rr <br />City <br />Clty <br />l�� i'-c�t �a�.,, <br />� <br />_ City <br />Square Footage (If residential new construction, remodel or addltion) <br />NumLer of devices (II low voltage) <br />Dc,crlption of Work lo Be Donc: <br />% �- �-�s <br />�iSo7�a��F <br />\_, <br />t,�� °/iZ�� . <br />Statc/'Lip Phone <br />S1a1NZip Phonc <br />wA. �iti�eE�s <br />Slate2lp <br />82z-2o�Z <br />Phone <br />, �"tt (: I `l <br />City of Everett Business License Number (requlred) <br />�%�D�°,° <br />Conlraci pdce of Work <br />TS C'w�2nN rsr-nw�.,v+�+'� ��,�wu c <br />Conlact PersonlContact NumbeUEmail <br />� <br />r SAv'N� �10, <br />/ <br />"L uru,.i�s <br />��G�+r-S <br />% -- <br />�' FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 OG <br />lfmreGy certdylhaf lh,ave read and examined fhis upplicallon and know fhe same fo be frue and ���� J <br />wnect. All provisions o/laws and ordinances govwning fhis type o/ �ioik v�iU be comp/eled <br />�ihefherspecilied herein ornot. 77�c gran�iny ol a permi( doeS not presume fo give aulhonty (o P[RMIfTf <br />vio/afe o� cuncel (he provls/on, o/ nny otlrer sfale orlocal /aw regWa(ing cons(ruction or the <br />wo�k for vhlch applicafiorn Is atde and l comp/y k�fl� 7ho Sta(e Coo(riacfos� a��18.27 RCW end � I J��! ��� <br />29G.200 WAC. <br />OG <br />nrw;rooe�ctzo�r �I��L .,.� �(�_^ . <br />�r <br />