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4ua. 1�. "[Oi3 1 : 55P1S No. 56"l� P. i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320� CEbAR STR[ET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-i1857 —�wrw.overettwa.org Q_ '6 y �3 <br /> �--1 � D� �-0 6S� <br /> I .��� 1�'eV�'\` 1 l--Y�f'-P. k �c1rkV�,7C� C:l <br /> PROJECTADDRESS '� <br /> Cltvl-���7r �� I,��C.� P���' S� V 7 � a-C��"� I`1C� rr', � � C✓�2 !c F� IL� ) 1 <br /> Owner hladAddiess City Siaiamp pn <br /> EvP�-�-��, ..� � `i �a�3 <br /> �c��n;� �_ <br /> 7enau MylAdd�ess C�iy siatorLp Pnone <br /> �r��-c�v�c.e. .br���1�, �2�a. L,��lkS1�r-�:� nr'iJe ��xklti! i� a L�)A- �I <br /> Elec�ncnlConUactor r�ta�inddmss Ciry �iaiortrp Ca�L'\ pono <br /> (n�a- b�l <br /> E'��wvc,s.�l �3 Q Z-. � a�, �1�t�-1 � 9'� <br /> State�cense Number � Contract Price ol Werk <br /> Cc-v-Y.rl�-e v �_� ,-�.l <br /> Proposon Use of Bulldinp Contnct Person (Plan Rnvlow) <br /> Squaro Footage(It rosidenfiel new consWction, romodol or addilion) <br /> �`1 <br /> Number of devices Qf low volwgo) <br /> Dosaiption ol Worfc to De Donc�� p 4�� . ) �L����—�t\\ �j,. p-!� ��= (`,�C�S�� C n �1-`YG I I <br /> � C� �V,, +� l 11 C`v.c1.� �� u� ', p CL1�cJ� L' L� YY..� �!'�� n.c��.V"� �. 1'�c` , <br /> l <br /> '�(`l,��C��1� �\��7�� �.� � <br /> fE[ <br /> CITY OF[VERGTT LOCAL SALFS TAX CODE IS 3106 t� �.:.�/1 o p <br /> c�lJ " <br /> +heroby cortity that I have�eed end exemined fhis applicafron end kr;ow fhe same fo bv tnie and <br /> correct. All provisiuns o/lews and o�tlL�nnces goveminy(his typo o/worN wiil be complefed <br /> �vhofAer specrfied Aert�in or not The gran7m�01 a pemUt does nof prosumo fo nrvo nufhadly to pE�17'g <br /> wo/ato orc�ncrl the provrsions ol�ny oq�orstafo orlocNlaw reguleNnp ca�Nrucfion ortho <br /> parfum�ance o/consfn�cffon. Tha11 om eufhunzod 6y Iho ow�nor ol fAls propedy to perform fbo E I 30 g — Q�Q 5 � <br /> woik 1or whicb ypplicafion is made enU 1 co�nply with!he S(afo Gontractors Lew 18.27 RCW and <br /> 296200 WAC. <br /> c�� � � � �l � �.� , 3 <br /> Slgnfllu7t�7 - oetc <br /> �,���,� �5 �I a��� Cc� I S�t rc� �G(� -o - �,� <br /> C�2�- lC CA rcC, �Cl.l.1�Q.�.'�' Q'}F RrJU:Y Y�'11 �] ��. <br />