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� �. <br /> LECTRICAL PERMIT APPLICATION <br /> ; CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, Wq gg201 <br /> 425-257-8810 - FAX 425-257-8857-v,nrnro_e�erettwa.org <br /> � �Z-/�-�4 <br /> � C-� 4 �z-v�z <br /> -�� � � �� �� L ,,,�r! � ^ �. <br /> PROJEC ADDRESS � <br /> Owner '. Malnddmss <br /> . �'ry StMelZip Phonc <br /> `I�\,llrr•�I-nr ct � � If (` rrr �c_ �`��1 i�le�'r,l� (' rcti� �/,� b !� <br /> Tenant � MailAddre s �� � ` �r�c � ��-��µ 7S �L 3 <br /> , Sta�c/Dp Phpne <br /> 1' �'1c; �r,.�i� 6: ' �� erni'Cr.�. Ln� .,.35"' .S i.S 2,�J - � c -' <br /> Etectrical Corhador r�� �r ' � .�a. , C�111� �S'�= �� <br /> M11ai1 AdtlmsS City — <br /> SIa(el2ip PnonC <br /> =��' '� s� Ssl3 � I <br /> State Licen c Number(re uired) <br /> � City of Everett�u5ine55 License Number(required) <br /> � � �i ! <br /> Ill til'�, S-l:l v� 1 ` IG,3� <br /> Praposetl Us<.of Bmtding� -���- <br /> Contract Price ol Work <br /> i <br /> � Square Footage(II reside hal new conshucbon, remodel or addition '�'�n r ��r \ . c ,��.! <br /> I ) Contact PersoNContacl Number/Emal1 -- <br /> �75:3-7a.i/-..�5-'3.�Pe-t1 <br /> � c��3� <•y!- 13s/, u�4-�<<- I <br /> Number of devices(If tavi ollage) � y 'rSGi y��;��, �c.��.. <br /> tn�a,l : i nrto� y s <br /> Descnption of Work to Be one; �,�5�-p (( �1 r � ,�,. ���) �� � <br /> - '�L�. J .���t-2��-F'� <br /> � <br /> __ <br /> ' FE[ <br /> CITV OF EVERETT LOCA 'SALFS TAX CODE IS 3105 � <br /> I hereAy ceqdy fhaf!havo �d nnd examined this appLcation anU know Ihn same to Ge lrur, ond �O <br /> contcL All provisions olla�s and ordrnanccs govcrninq fhis type 0/work�ir;l he compleled <br /> whr.thc�speciBr.d herem or noL The granfing ol a pemn�does no!presume ro�ive avfhonty to PERMIT# <br /> v�ofafe or r,ancol Ihe pravisi os oI any OIhOr s(�to cr local law regulafino consl�ucfion or lhe 1 I <br /> perlonnance o/cons(nid�o ; 7h�f f am aulhorizeU by the owner cl llris propeRy tn perform fhe E �-} 1 R <br /> J�ork fonvlrich�pplica�ion i matle and 1 compty n�i7b fhe Slale Confractors La�v f827 RCVV and I I I �— O " � <br /> 296.200 WAC. <br /> � <br /> ' �[S.•i,✓AJl.li_ �'w. �•i �,J - /U - / �/ <br /> S�gnatmr. i � UaIC <br /> l . - <br /> PIYGCU 96TK40+p <br /> _. `� <br /> £l � 6;£l l68£9L yoel swe�s,ts eni�enouul �b0 E0 6l Ol �ea <br />