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i • , __ <br /> � LECTRICAL PERMIT APPLICATIQN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, �NA 98201 <br /> 425-257-8810 - FAX 425-257-8657—wwi,y,everetMra.org <br /> IZ .,II —I (� <br /> E�y�z-�-� � � <br /> �1�1' ti c�a , I , �,� . , . <br /> PROJEC ADDRES ' <br /> I ' <br /> Owner � MailAtld�Esg <br /> . Ciy State/TJp p�� <br /> �'r, � ��- ��•. � � �. r��r iv� � <br /> e�^r�1� rze k k4 ,: � ;,���c. t 4� ��k.�o 3 <br /> 7enant ' f�ail P.dCmss <br /> . ciry Sfatc/Zip ananc <br /> .�' 'J\:'n;�I � Ib � • c�� 5'CLr�l� LIlC. n_3S".C1Sfa.i�.iL�r � <br /> I <br /> ElecVical Contractor � Mail Adtlress �N �h7 / •/ r Ct1�t )S"� 9/ <br /> i State2p Phone <br /> iN :i' S yY13`l <br /> Stale License Numher(r2qwred) City of Everelt Business LiCense Number(requirtd) <br /> ' � i�'l,437,�,� <br /> il l u�-!' �-cv„�,� I . ; <br /> Proposed Use oF BwlOmgl ; Contract Pnce of Wark I <br /> I <br /> Square Footage(It reside Ual new consiniCion,remodel ar adddion `�S�n� j� � � ��' � �L'� <br /> ) Contacl PersonlContan Num6eq6mad <br /> I :.?.>.',3—(:.S!—.�a-S.�ec�! <br /> �,.5_9.. .__q�— r��� r, �TF�c�= <br /> Numoeroldevices (Iflow ollage) t111w� � � �tlLG�l-d�ST.��iyCi,.���, [+r_•,�., " <br /> i <br /> Ocsaiption af bVork to Be one. ,1�I1 S'�it �� ��-f ti Kl�i� �r � , i �f ��0.y V, <br /> —� <br /> Ii - <br /> rEE � <br /> CITY OF EVER[TT IOCA ;SALES TAX CODE IS 3�05 �� <br /> f he26y ceh�/y ihaf 1 have ead antl exam�ned Uiis applicafion antl know fhe same fo be hue and / <br /> correct Afl provisions of fa s antl ortYinances goveming(his typo o/�vork wd!be comp/efed <br /> whelherspecified hemin rn noL 7ho granbng o(o p�rm�t does nof presumc(o grvo aulhoriylo PERMIT# <br /> violatc or cancc7lhc p�ovis ons ol ony o(hcr SWtc or Iccal la�v rnqulating conshuclion or fho rrr fff fff �7 <br /> p.Monnancr o/consfrocGo�r.� Thaf I am aulboritcrl6y 7ho owncr o!llus prapcAy fo peAorm the E I L1 I � � /� <br /> work lor tvhrr.h oppficafion��madc�nd!compty W�fh !he Sfate Conlractors Law f8.27 RCW��d 1 I ( <br /> 296 200 WAC. <br /> \ � <br /> l� � i <br /> , iC7.•Iy�LJFA L �, u� l� - �� - � y <br /> $itjfl'(UfC I � i DdiC <br /> i <br /> hFYt:.fO OftS�Nia <br /> I � __ <br /> I1 <br /> gd �9£l l68£97 4�e1 swe�s�(g eni�enouul �ZO FO bl Ol �e0 <br />