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r. _ —_—_ _ _.'— _" — — _ —__—____ --_� <br /> � <br /> i ELECT�IC�.L PERMIT APP�ICATlON I <br /> I CITY OF EVERETT PERMIT SERVICES � <br /> 320D CEDAR STRFET, EVERETT, WA 9820 i i <br /> � 425-257-8810 - FAX 425-257-8857 —���'�n�d everettwa,org <br /> � i <br /> `� I <br /> � :�U J� cr� <br /> � � a- C i <br /> PROJECTADDRESS I <br /> I <br /> ; Lu �,< � u� �4 �� � ��e _ - � <br /> iOvme� 1.laAAddress C�;y StalelLp Phone I <br /> ITenanl L1ail Address Gry Sla;elZ�p Phone <br /> � I / /� QA� <br /> I �C10� Se�SC F�( [ 'lfi< LCL I��t�( IfeO w� \ IL'�7� <br /> Eleclrical CoNracler Lta�i Atldress Gry State2p � ncn_ <br /> I y�s �3�s 3� 8 <br /> i G�en 55r- 4�-3 70 ��3�^1� _ <br /> State License Number(reqareA) City of Everelt Bus�ness License tJumber(requ�red) <br /> ' s,�.����_�l`1 <br /> '� Proposed Use ol 6u�����ng Cornract Pnce ot VJork ` <br /> � Square Feolage(If res�deN�al new construction, �emodel or addd�on) Contacl PerSonlContact Number/Emad I <br /> � <br /> I <br /> iNumber of devices(II la�v vollage) <br /> � L7escriplwn of VJork 10 6e Done� __�i��g��_��.p_. �^�'J d'Uu�_ ��4c� 1-'C C'✓�_� f���� <br /> � �' �2 4� lM[�C.�� SSG... S�� -- ------ � <br /> � --------- — <br /> -----— --- _—_ - <br /> F[[ `--- ----- <br /> CI?Y OF EVERETT LOCAL SALES TAX CODE IS 3105 / � D� <br /> I 1 hereby ced�ly thaf I have re�d and examined fh�s�pp4r.a6on and knoiv fhe sarne fo be hue and _I___._--_— <br /> corred. Ail provisions o�la�•;s and ordrnances 9ovemmg this ty�;e ol work�v�li be complefed — --------- <br /> nc�lher sper,il�ed herein or nol. The yranhng ol a pennd does nuf pr�sume to give aulhonfy fo P[RI•7ITY. <br /> �� violafe orcancel(fre provisions ol�ny other sfale orlocallawrey��lal�ng eonsfructi�n or flie � ��O I ^ O �'j 1 <br /> j peAormance of censlrucfron. ihaf 1 am au(honzed!ry lhe o�vner ol fhis p�operiy to peAo�m fhe (i � <br /> r:oik(or�vh�ch appl�caGon is rriad an I cumply�+�uh the State Confrac(ors La�v 18 27 RCW ivd <br /> � ?96.20014'AG. � <br /> � I� l_ /�—/� — <br /> i ignature Date <br /> Li�';<E0099cr,Ju ___'_ _ . ' _ __ _ "_ _ . __ <br />