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� � <br /> �LECTRIC <br /> AL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, Wq gg201 � <br /> � 425-257-8810 - FAX 425-257-8857_�W e�erettwe,ary <br /> i <br /> i �Z "�( �l� <br /> IJ�� 1 ' � � ' C Iy/2-6 ?�y <br /> PROJEC ADDRES ^ � r ` r - �_ � <br /> � <br /> . i <br /> Owner <br /> . Mal Atldress <br /> c�y <br /> SIq1UZip Phcne <br /> ���11. " n, C'` I ' ; � . . <br /> TenaM , . � ' i. �°!or I���.�"f��i rez f1 � k � � �'e�'a t" 1 �,. <br /> I MailA�dmss f (,� ��G � <br /> ciry Slatc/2ip -- <br /> PhOnC <br /> .1—�1�\Cl �[I��ICN. � 2� 7ST" . <br /> Electrical Contracior � cc� �"� ''�S. C_�c Q.,�.J . <br /> Mail Aedre^,s ��� � � �G�_.o !. �11 n i-� � <br /> City <br /> SlateiZip <br /> �-'W ;i'lS. g:Tit?` Pnonc <br /> State License Number(rpquired) <br /> � City ot Everetl Business Licer�se Number(required) <br /> � {-G � 't r� <br /> PropoSed Use of Buildfn %�' . �7� / L' f <br /> I i <br /> ' Contract Pnce ol Work � <br /> i <br /> Square footage(If resiAe hal new consirud�on, remudel or addilion) ��-`L�`�� �- <br /> � F�� C •c� �- <br /> Contact PeisoNContact Number/Ema�l <br /> i •1.�? - !I <br /> � '� �7��/--.�ti'?3.�-C��� <br /> Number of devices(IF Iow 4oRage) "1�', ' '����- J����• .�}�=;��_ <br /> I t.�„ct.I: Ihr'lGi, SyST.�L/vC�2tG�. eGh,-.. <br /> ij Desaiption ol Work ta�e Done. � ���_�-.��� !a_�. ; � ' ' <br /> I .� '�l�t r r•i ' r I J -I +r <br /> I ' <br /> I <br /> C�7Y OF EVERETT LOCAI 'SALES TAX COOE IS 3f05 FEE '\ � <br /> !hereby cr.rtily fhal I havr ad and examincr>lhis app!/calim nnd know D�e e�me fo 6e t�ue and ��Ov <br /> r.r,irecf. �q p�vvisons oll. ws snd adinanr.ec goveming fhis lype ol work wdl be cnmplefed <br /> >vhelher spec�ed l�e�em o nol. The�ran(ing ol o pormil does nof presume to g�vtt authonry�o -_�-- <br /> viorale a canr.e�mo nrovis�on;o/anyoUrcr s(ale orlocallaw regulalrng conshucfion or 1he NFRMIT# <br /> work onvlucry�ppJ�co on�s marde und!c�ompty��h IAe SYate Con1 3�Uors La v 7C.?7 RC�,yl�nd <br /> 29G.200 WAC. E I � J� ����. + <br /> � �-' I I <br /> `_'_'----J <br /> �\����-'i�rA �� L �i-t�l i:,� . <br /> Signature � I �•�� � /U ' / �/ <br /> / —p�" <br /> �+f v�;Fn oP✓ps7ar: <br /> _ __ � <br /> ___"__— "__�—__����-�_" <br /> ?l cl 4SCl l68£SL I�DAl SUlBj5�5` BAI�f!�pUU� �50 £0 6l Ol �AC1 <br />