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� <br /> ; <br /> LECTIqICAL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES I <br /> 3200 CEDAR STREET, EVERETT, Wq 9g201 <br /> •, 425257-8810 - FAX 425-257-8857—www,everettwa,org � Z`/� /� <br /> � <br /> � <br /> � s, . � . � C—�, y,z--o�� <br /> � -' .• ° ' .� ; f .� � 3/ � <br /> PROJEC `ADDRESS <br /> � <br /> Owner Mail ACtlmss <br /> ��N Stalc2iD Phone <br /> '-�t��, � „ �, c_ 1 . ' I '` , � 1tiu� f�1e�^r�l� (` rezl� P�, � <br /> Tenant l � � �. �'a �•r i r' (t)F} �/K'�( 3 <br /> Maif Adtlmss C�n, <br /> , SlatrJLp Phonc <br /> .LYYvIf.��in.�i�'� � -�e� iSTt�.�� Li�� C� <br /> � 35^ .0 u.:4J ^ 1' �c r_ 'c, , U_�1' ys'3 � <br /> Elecfical Conlrador ! ldail P.tltlress - <br /> � ��h' SIa1e/ZP P�onc <br /> .i iV , �S S'3/3` <br /> State l,icen Number(r uired) City o(Everett Business License Number(reqwred) <br /> � � 3?,`" � <br /> _Ll:��l � �-�y,�� � <br /> Proposed Use of BU.Idin <br /> COntracl ptice of WOrk <br /> \ i <br /> Square Footage(If reside tial new conslnidion,remcdcl or addition) Cont�act PcrsoNCon ad NumbeqEmail <br /> I I ' <br /> I .a.�:�-b.�i-�t,-�.�a,�ri <br /> 13.�;?_ ;";r- ,:a! U}}=� c== <br /> Number o(devices QI iow olfage) ���,��,�'� S ' � � <br /> I tlY�::,.� � `� 7;i •/ ��0.��. C��:rl�.. <br /> Descnp6onofVVorkloBe ane: i i1 •;�c�I( I� � > �ccc.�,�� �� I •i i1 <br /> �r_ <br /> i <br /> ' FEE -- <br /> CITY OF EVERETT LOCA 'SALES TAX CO�E IS 3105 I=P-� � <br /> I her=6y r.eRi!}•fhat/h�ve� �ad and examined lirrs aoplicah�on and kno�vlhc same fo De lnie anU � � <br /> cormcl. AIlp�ov�sic:�s o/la %s and ardinances goveming this rypu of viork will be complsfed <br /> whother specified heiein nr nol. Thc gianfing ol a peimd does not presumo!o yive aufRonty lo pERMITx <br /> vinla(r or canr.e!lho provisr ns of any other stale or bcal!aw mgulaGng consfruchon orlho � <br /> perlormance o/consbucfio . 7hat!am aufhonaed by fho owner o1lhis property lo per/orm thC E I I 1 I� �O�� <br /> worklorwfrich application i made and I comply wi(h/he Sl�7e ConfrdGors L3w 70,27 RCN�and � <br /> 296.200 WqC. <br /> \ <br /> I <br /> � �C:,�4, �,` . ,�i <br /> Signature ( � u' �Date/[J - ( c% — <br /> � i <br /> i <br /> RL1'�SED 06D6?OI•t <br /> g d b,£l l6B£9Z yoo� sweis�cg oni�enouul �F.O £O bl Ol �00 <br />