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� � <br />ELECTRICAL PERMIT APPLICATIOfV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT <br />425-257-8810 - FAX 425-257-6857 - <br />�!t+/., i I'. L JC �C'i"'Fe. � S� LViiYL%i" <br />�'v � ( L1: �-� 5r <br />PROJECT ADDRESS <br />�Hlci Pp � �, �.Fi`'� EvllLc-r�- <br />O�mer <br />G,�:,N»����L c.t <br />Tenant <br />Mallllddress <br />Idall Atltlres; <br />Cily <br />Clly <br />,�VA 98201 <br />Wf w 1.l1-�° ✓Gr�'f yt �JsZ. <br />'trJc'1..�t1 t1 <br />�U(J ✓ <br />7-3.o-+S <br />� � 5 °7`� <<'1 <br />w;� 9vZU� <br />Stale/Zip <br />State2lp <br />Phone <br />Phone <br />���CDv.u�� ��c�'n2�1; PG 13ax `IB`� l,C��'-t��aN� LJq, °I ��D%3 �ylS)£2Z•Zoi2 <br />Electrical Contraclor Mall Adticess Cily SlatelZlp Phone <br />�����.��.��E z 3�� ��t <br />State license Number (reyuired) <br />��o�ru,lz�,�-s <br />Proposed Use of Building <br />Square Footage (If res(denlial new construclion, remodel or addition) <br />� <br />Nvmber of devices Q( low voltage) <br />Dcscrlplion of Work to Be Done: �CS <br />Sav i r✓ � <br />�2�i;�y <br />Clly of Everet� Business Llcense Number (reqWred) <br />.� Z�j�, (� <br />Contract Prlce of Work <br />{ � C"V�Y��hl T;t'c'N1n9uw2� �v����ft 4 <br />Contacl PersonlContact NumbedEmail <br />�n�n� FnN t ) 141:Ji,l fC��qS Z �ivr,c�, � r, <br />CITY OF EVERETT LOCAL SALBS TAX CODE IS 31U5 <br />! hereGy certily Ihat I have read and examined Ihis applicalion and know (he same (o bc truc and <br />correcf. A/l p�ovisions o/ldiv; and ordinances governing this lype o/work will6e comple(ed <br />�vhe(hersprcilied herc/n o�noL The 9ranting ol a pcimr( does nof presume fo giva aufhority fo <br />violafe or cancel (ho provlslons ol any oflrer sta�e orlocaf law �egWaliirg constnrfion or the <br />pedormance o/consfruclion. Thaf ! arn au(hodzed 6y (he ownero! fhls property to peilorm fhc <br />wwk !or whlch appOcaffon Is made and I comp/y �vilh fhc S�afc Con(rac(ors l.a�v 1827 RCW and <br />296.200 WqC. <br />RLVIS(p 09iDU.0!< <br />---- r3 � i. (� <br />��G,-+r� <br />F[E <br />�5�0�� <br />PERPIITJ; <br />E I�b�-2�I <br />