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; <br /> � � <br /> � <br /> � <br /> LECTRICAL PERMIT APPLICATION <br /> C�TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE�', EVERETT, Wq 98201 I <br /> 425-257-8810 - FAX 425-257-8857—tir�,everettwa.org <br /> "111 , IZ —i�� <br /> 1�,= �„ � �. � �l . , '� L�l�f!Z <br /> PROJEC AODRES 1 '� � <br /> I i <br /> OvmOr . t�A�ilAddress <br /> . C� SIatPJ2p <br /> Phnne <br /> ��r..,� , ��- ; - r � �. i-��� ,,� ^ . r� <br /> Tenant . � C� f:� t"�'� I� ' /S • ii � U1ic. <br /> , MailMtlmss � ��� �,tK.:Qj <br /> � Cily Slate/Zp <br /> Pnone. <br /> .L l�\�/I)C��t�'L'. l' . .B� STT.:\ .(hc: i S" C LS 2.�,j . —, <br /> Efectric2l ConUactOf � �dail Atldress n`' ' r�� �c � , �� �)1 ;�b• � � <br /> � �'h' Slace2p <br /> Piwnu <br /> 1 (�1 �i�'.] .S'Sl l3 � <br /> Slatc Lixnse Number(r quired) <br /> City oi Everefl Business Llcense Number(requinetl) <br /> 7� �� t-� ' �14s7,�,� <br /> Proposetl Use of Bwldin � I <br /> � Ccnlract PnCe of Work I <br /> Square Footage pf reside ti�l new constmdioq remodel or add�tion ,"''ir�' ��.'' \-�.n � .� _ <br /> 1 �ontaG PersonlContact NumbeN[mail <br /> I ' �'�J:3—�OvJ �—J�1'�/ J_�lL1 �! <br /> 1 U.�JZ.. ��i/�' �J-�1.4 �� �T-1C:1- <br /> Number of devices(If tow ollage) ' ' <br /> tnt::.I: � hilc � s�57�6iy�,a�, /, eo.r� <br /> � Desaipbon of Work to Dc Donc: �,,, ;l S'�A.II �� � ', ����) -,�� � � r <br /> 1 I <br /> I <br /> FEG -- <br /> CITY OF EVERETT LOCA ��SALES TAX CO�[IS 3f05 oO� <br /> I herchy cenily that/havn oad and exomined lhis applrcalron und knovi Ihe same lo be lrue and � <br /> ICO7Ctf. n17 provisions M 1 �ws and ordinancr.s r�overnfi,q fhis type of work wi0 Ge compleleJ <br /> whpfher spec�ed heiein o�not. Thr.gran7rn,q o!a poimit does nof presume to�ive authnnry�o PERIHITB <br /> violnte or cancel7hr,provis ons of any oUirr s(a(e o�locnl la�v iegu/aling cnnslruclion or the <br /> �work lor wh ch applrcat on inedo anJ/comp y��h fh1e Slate ContraGors�La v f a 27�RC W ontl � I��� 1 O�� <br /> 2.9G200W�C � <br /> \, <br /> Ji_�_L.N_S.' � -�:� i.i <br /> 5������« � l� - �� - � y <br /> , Da�e <br /> R[N1:[OOLDWd�14 <br /> 9l � ycc L 16869Z yael swo�s�(g onqenouu� �1SO EO Vl Ol �00 <br />