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09� 11;"�O] J 16: :i� F.\.l J.595J883a E�'e�'Ft•een Se�.uYlt?' 1100: <br /> • • <br /> �- --- � -- - ---- <br /> I <br /> � ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEOAR STREET, FVFRETT, WA sa20� <br /> a75-257-8810 - FAX 425-257-8857 -www.everettwa org <br /> �� ��-�,�.i-� A-�-� <br /> pROJECT ADDRESS i <br /> l2Ll•vr�_4-c/wY1,4"L'L�a1 �1T-�i `�.�, l�i� �� � � ��S'Z� _ <br /> O�vner !dall AAems., Clty SleteRlp ��l\�r�Pr.o�� <br /> r t�)!J� ,7L <br /> �N�'�OLtSYI•1'UL�3✓1 2�{'a✓(�A�Q, }�. C�� � gf O "uP�1t�'I,J�- �1��O <br /> Tr.nanl MailAtldre:s Q— C�ry StalrlZ7p �no�. <br /> �flx'3HF'c-s85C� <br /> C�vOrfnYe�X1 �2'Ce,Wl,l t� �115 ��au�•py���'tc�� C--v�e� W►�- �� <br /> ' E'¢ct�iGal CnlraGior M1 ad AOJ2L6 '�G ly SIaIr.�Lp "�o�e <br /> ��� ss� «. � ��a° � _ <br /> Sta:r License Numter Contracl Prce of Work �� <br /> _ ��rn,NL1t,,�•,��Q .�,ti-.t<h M�+r <br /> PreposedUse o{pw�ding ^' Contoet Person (Plan Rev�ew� <br /> , Sqd�rC FootOge (II residential new cansJuttian, rBmodni pr addiUon) <br /> Numbnr ot tlewces pf Icw voltage) <br /> I n <br /> I� DCSCriPhOn nl WOrk to Qn Don� il.���^'Q� U(N, v v l �N ``" ` lN � '/`�'�� <br /> i �✓ __Y�Q�t7 QZW�"l v1?i� (�U�S• — ---------- <br /> I <br /> FEE <br /> CITY OF @VERETT LOC/��SALES TAX CODE IS J105 �� . I � <br /> I hcrcby cr.�rily u�at 1 bavo rvaJ and oxamined Mls appllca6on snd know fhr sarnu to Go fruo and <br /> conecL All provislons ollaws and ortYnarrcos govominp fhls type of work will be complefed <br /> whefner spac�fo0 hurem or not. T�e grnnNng o�o pennif rloss not p�esumo fo prvo aetponry tu PERMITi+ <br /> vrolofc orcanml thc pmvisons o�any olhyr stafo oNowl lew mgulnVng constniction or tAe <br /> pedormance of cons(nicfion. Thr+(I nrrr euthnnzrd oy fha o�vner ol fhrs propeRy to pcAo�m the E ( '�0 3 .- b 3� <br /> woik(onvhich applicafion�s m30e and I comply wlth Nc Stntc Contmc(o�s Law 7B.27 RGW antl <br /> 296.2n0 WnC <br /> ��-I-� �-4 <br /> 5, ure Onie <br /> fif��.iEOY.'J�U <br />