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i- • <br /> ELECTRI�,AL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRFET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettvva.prg �L `� � �((� <br /> C- ► �iZ --a��/ <br /> �"1i1��11��1c�ot,_ �1- �11t+rr�!( �� ,-r .� 1• ii��) ,�. '1 <br /> PROJEC'�ADDRESS � <br /> Owner MailHtldmss Ciry StalefLp Phonc <br /> Tenant 2 , L ��U� j1`�CJ'ft�� f'eC � {; �' �tir. y" (t� �C. 0 "3 <br /> 61Bi1 Atltlress C�ty SIaIMLU PMne <br /> 1– l lifn'� �� C/. � . � e S r� �I�c_ . �S^ .L5 �i., l �L'tlilrl� (rrr�_�J r iAJ��� �5'j �// <br /> Elecinal Contractor` I.tailPddress Qry � SlateZp Phone <br /> lN ; bfi•J3�/ <br /> State Liccnse Number(required) City ol Evmelt Ausiness License Number(requiretl) <br /> 1t1;��1-I; 4'-a,n.;lv �'/.437,°�, � <br /> Proposed Use ol8uddmc CornraU Price of Wcrk <br /> �- .Gr�C(.lL't. ��tm C �ti�� <br /> Square Footage(If residerflal new consL'ucY�on, remOdel or adtldion) Cantaci PersonlCOntact NumbeUEmad <br /> a�s -6s�-3a�s�c��� <br /> I �53. ;.9i- l��f. Of{-'��� <br /> Numberofaewcespflowv��ltaye) Eil1u.� : �n,toL�,iySy�jL/y.'L��y.e1(, (rc,T�„ <br /> Uescnpt��n ol Work ro Be Dpne: �_�'��(�� �'���, J :_n�,I ')��'{�y <br /> I <br /> � — - <br /> FEE N-� <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3705 �1 W <br /> I heroby cendy tn�f I havo r ud and examined thls opplica7ion r�nd kno�i�Ihe same fo 4c huo and v V <br /> r.orrect. !J!provisions ol!av s ond adinancns govcrning fhis type uf work wdl be cump/cicd -- <br /> v�hclhr.rspeafrcd hcrcin o��a! 7ho grantirrg Of a p�rmil�acs nof piosvmc ro g�,o aufhuriry to �pERMCiK <br /> vrolale or r.�ncel fho Provrsi� s ol ony p�her SW Ie o�!^„zl law re�uln.'�ng consHudion Gr lhe <br /> pedoim�nCC ol�OnslNclion Thaf 1 am aufhaireo by Ihe o�vnor o!fhis�.o�,eny ro�err��„u,� E.I��._D�v. ' <br /> v:ork Icr wluch AppGcaGon�5 made anU 1 comply wdh Ihe SfalC ConUacfors Law 1Q17 RCW.ind '� <br /> 296 200 WAC. -- - <br /> ;� <br /> �� � �- l� - iu - i�1 <br /> Srt�nature Unte <br /> npvr:rn cM���+ <br /> � �f �9ELlGACSZ yoolswo�;,tganqenouul d1060V1O1 �o0 <br />