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i_ -- — ---. • — – ---•---- -- _ _ _ -- � <br />I i <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT WA 98201 <br />425-257-8810 - FAX 425-257-6857 - <vww.everettwa.org <br />I� 5% O lo ��i ��i lc � rc� �� <br />' PROJECTADDRESS <br />_c��vvr� I Scr vc.��� S�a� - i%�G,��„�/ �� Pc.�2err _ <br />Owner L1ail Atldress Cdy State2ip <br />Tenant 1Aa�l Address Cny StatM7�p <br />Electrical <br />I ( U/Z I e zZ00 SJd! <br />I State License Numbrr (reqwred) <br />�� 5 <br />��, Proposed Use o( Buddng <br />S9o�! zz�� Sr sc.) �%/T <br />M1ta�l Address Cdy <br />Square Footage Qf residential ner+ construclion, remodel or addihon) <br />Number of devices (II lew vollagc) <br />'D�3 <br />Slate�Lp <br />Phane <br />Phonc <br />Phone <br />�z5t�3Z <br />Cdy of Everelt 9usiness Gcense Number (requiretl) <br />10�0.0� <br />Contracl Price of U�'ork <br />/'1�I�'c Lcu� ��'„Q �,rj �2oC 9�-17so s <br />Contact PersonlContact umbedEma�i <br />Descnptlon o( Work to Be Done�. ���r s'n �� �r ��• �%? ��' r r`��'� 1�`� i1 �'t ��� �" L - <br />7,.o s Tc l l 5 vu o/Gt iJe T� c 70�4 Cc J(� i.?C d: T-%a-r �C-.J�G I c_�Iv j..s <br />� �« �, �.� x . r ; , �,� �li �, i;r �, ; : ,,� ------ --- --- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certdy that I have rearl and ea�amined fhis app�ication and kno�v fhe same fo be hue and <br />correcL All prowsions clla�vs and ordinances goveming @iis type ol work �vdl be complefed <br />�vhether specdied hercin or noL The granting o/ a pennd does not presume to give au(hon(y lo <br />violate or cancel the provisions o/ any olherstc�e or localla�v reg�daGng consfruction or the <br />peAonnance ol construcfion. That I am authonzed by fhe o�vnerol ffus property to perfonn the <br />�vork lor �vhich applicafion is rnade and 1 comply wifh the Sfafe ConVactors La�v 78 27 RCW and <br />296 200 WAC. <br />ure <br />REV+SE00&D6llOH <br />�' �� <br />F[E � <br />PERh1Il'« <br />E I�jO Z-07(o <br />