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ELECTk�CAL PERMIT APP�ICATI01 <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, [VERETT <br />425-257-8810 - FFV( 425-257-8857 — <br />L'It+/ � I LJL�G'�ivQS G GVr:PGt+' <br />:� � � <br />l -b �.,.� 3 T <br />PROJECT ADDRESS <br />� F( �.1 <br />Owner <br />Gf i i•11"�) � ��� V <br />Tenant <br />i � h� i� t�7'- � <br />Mail Address <br />G��r � j. <br />tAail Adtlress <br />, WA 98201 <br />u1 c,� i.�J - E���i _fi c�� <br />W;t. ��:/ <br />�J <br />C�LI:.�T � •. <br />'-'v� <br />City <br />Ciiy <br />J° <br />g_i 0—�S <br />E isa8-dU3 <br />Stafc/Z�p <br />State/_�p <br />Phone <br />'hnnc <br />���+�uJVi:IG\�= ��Z�I1�IL i"4 r;'J/( li�� ���1=1�-1.r`u.>>) �� � L. D- / <br />�. �V�uS 1`�Z)��'ZZ'ZCl�. <br />EIeCl�icalContr�ctor IfailAddrzss City State/Zip Phone <br />��',', �u«,.E r 3ci ��� <br />State License Number (requir=d) <br />l�cra� � �i.—�S <br />Proposed Use ol Suilding <br />Square Footage p! re>idenlial new wns(ructio�, remodel or addi!ion) <br />�r <br />Number of devices Qf lori volt2ye) <br />��i:iy <br />City of Evemtt Business License tJurnt�er (required) <br />�'�5b,00 <br />Centract Pnce oI Work <br />TS C"V�3.f�n1 T;Sc •�hn9.,w.^,.E� ��,.t ���u, 4�.� <br />Contact PersoriContac; Num6edEmail <br />DescriptionolVVorktoBeDone: CCSn'•T�L (����j�(,'y ��AV;r,� �(,�.�au��r.tl��e�7�y- 6E= ��6r�Y� � <br />�n�Tl-I �-I�r�> � I�l:vi,L it_�)S � L . _ ^�=v: '`' — <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />I hereby certily that / have read and examined Ihis applicaliwi and knoiv (he same fo be true and <br />conecL AIl provisions ollaws and erdinances governing this type ol �vork �,ill be compfefed <br />v:hether specified herein o�noL 7he gianfing o( a permi( does no! presume ;o give authority (o <br />vielale or cancel the piovisions o(any other state orlocallaw �egulating consVuction or the <br />perfomiance ol construction. That ! am aufhonzetl by (he ou�ner ol �his property to perform the <br />�vork (or a�hich appl�calion !s made and / comply ivifh fhe Sfate Contractors Caw 78.2� RC'N and <br />290 200 WAC. <br />.� , r, • � <br />: w �•t � <br />FEWSFOW,tii.M!� �r�LL —� L /� <br />! <br />FEE <br />�� p0 <br />Pr_RN�rr;� <br />E►�o�-b�13 <br />