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Dec251411 tf3� P `' <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERE7T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425257-8810 - FAX 425�257-8857 -vn•nv.everettwa org <br /> �z_ a`3 �ry <br /> � � /�//z _pcio <br /> j 35_�� ]1 rrr�-m�, 1��� <br /> � PROJECT ADDRESS �UU' - 3�O ��� <br /> (11(� #� r�n-i�r��l Lis 35a� ►'lar�(-�-v� ��;����" I��,a � g � 1 <br /> I htail AEtlress C'ry S���p P��� <br /> Ovmer � <br /> '.ta�l AJCrnss Cry SlatelLG Phonc � <br /> T��3�: y� �335-�FD <br /> �1vrdSi-rar�1� CC��-�.v� �}�-<-,� �-►-1 i"1 �i'��'Y'�-j,��'� �- vL�-r ; l.l%_ <br /> !, cleCUC31CcnUattor Mailiukk s Ciry StalelZip PMre <br /> � 4�dr �s!-!-�4 �� `�K l� c�ti �-�4 I <br /> Stale license Number(requred� C�ry o(EocreC�usiness L�wnse Number�requirea) <br /> I �l.��U �]�a <br /> Ip�o`�sed Use of BuJding Co�trac,Price ot Work <br /> �.e.L�-���-�-�`�, 3a��-�(oa� <br /> Square Footage pl msidencal new consWd�.on, remcdel or atldilion) Contaa PorsonlContad Numb�r�Ena'�I <br /> 1 <br /> Number o'dehces(It low voltage) <br /> ICzscn�Uan oi 4Vork ta Be Done: v 'e-�1 '� �--�StC�'t C�n � v-�CU '�n e�_ �au%VJI <br /> f r-�e <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 I j 5 0� <br /> !ho�eby cerGty tnat 1 have mod and oxammod this appi�caGon and kno•.v rhe s�me to Cc(roo ar,d I <br /> cared. Ali provis�ons o/laws und crdinarres 9oveming Uris ype ol work will be canplo(ed <br /> who�her srecifiod herein or not. 7he qran'ing ol a pemut does no�prosume to give authority ro PERMIT+� <br /> wofate cr cancel f�io Frovisiars of anyofhor sYa�a orlocallow�ogu':,tfi�ccnshuctron or tha r� �� I� " O �� <br /> pe�lonnanm ol tonstruc+�cn. TAot 1 am author red by�ho o•rmer o!this propert}•!o perlorm the C <br /> �.�en:lor which app6:ahon�s maoe and 1 r�mply v�dh tha State Confractcrs Law 18.27 RCW and <br /> 296.2 INAC <br /> ��_�jc�,vti,� ja- - 30 � � y <br /> Siynaturn �°t0 <br /> H�-�'�OJSAS:?I! -- -_--_ - <br />