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ELEC�ICAL PERMIT APNLICATION <br />PROJECT ADDRESS <br />t i-j �1 <br />� Owncr <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDnR STRFET, EVERETT, WA 9fi201 <br />�325-257-8810 - FAX425-257-8857— wc,-lL�-CI�GieL�":�rt..�i>f <br />ei..,., � ��:�e-+-{�ps G e�.�e,-�r-f r��.�_ J�v `" <br />( ��l N E <br />P� �i�F � 'j�l <br />hlall Address <br />GiLvlwt�b��t �l; b��Y�j. <br />Tenan! ldall Addr=_ss <br />E � L1L�'l'(' �—�i. �� �` Z J � <br />Gity <br />Cily <br />Slale�Zip <br />Stalc�Lp <br />Phone <br />Plione <br />1 � 7 � <br />' ���':��: �:1i'- ��L�� IC. ��C i:'J �t `�ytl V-t 1=:L�.A�.nl L�.iO. �� 1.' C L' 7 ��� 7 j� � ZZ � GC' I �. <br />Elec!rical Contractor t.tal Hdiress Gty State2ip Pnor,e <br />l�.' �p.;�E i 3�� �.�t <br />Slate License �•;umber (requtred) <br />f�Gr.,^�t�,-,JCS <br />Froposed Use ot Buuding <br />Square Footage (If residential new construclion. remodel or addition) <br />� <br />tJumber af devices pf lo�v voitage) <br />Description of YJork to �e Done: CC�S�ti=�l1L <br />;.� v i: i y <br />City oi Everec Business License Numher (required) <br />S� ��5, �% <br />Contracl Price o( VJork <br />l -� C'v,5ii..iltJ TSG'I+tnqAlWr,.tiQ2 ��w l�r.�u,4.'� <br />Contact PersoNContac! NumberlEmail <br />� SAViNI: h <br />`jLllTl.i F-nN � 1 lalv�-l' 1�-6i)S � C/1?cM/iS <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hemby certdy that l have mad and examined this applicafion and kno�v fhe same to br frue antl <br />conecL All provisions o/ laros and ordinances gaverning tbis fype ol work �vi/l be comp/efed <br />�vhe�her specilied herein ornoL The granling o( a permit does nof p�esume (o give aufhoiity ro <br />violate orcancel (he provisions ol any o,'he� state orlocallaw regulafirg construction or the <br />peAormance ol conshucfion. That l am aufh,aized by the o�vner o/ th/s p�operty to perlorm tbe <br />wor� lor �:�hlch appficafion is made and I comply �vith Lhe Stafe Confractois Law 16.27 RClNand <br />296.200 WA C. <br />ISignal <br />Lit6tiSEDC?L".rJN <br />�� � <br />r L L TV L(�i /-� <br />rEe -- <br />���.�5 <br />PERr�rrr, <br />E i�v� - ►�13 <br />