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06/07/2�OE 13:16 20624B7905 BRENNAN HEATING PaGE 03/03 <br /> � ' <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3Zu0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everetriva.org �_G, �_d� <br /> APPLICATIONS ARE ACCEP7ED FROM'1 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> '7`I��- �AI►.liC'R`�J C— o bob_����� <br /> PROJECT ADDRESS <br /> "�o�'Rr ��.�Y�.-� 7�.o�I-�a�Ni� �� ��lERE1T �aS- �55- � 4 <br /> Ownef ldall F.ddress Clry SlatoRip Phone <br /> TB�anl IdallAddT;s dy Stala2ip Phong <br /> �(�o► S ��tu�L do� -��g•'�9c� <br /> �F►.1.t.1��, 6{�`�I r.16�-�v A�� —I-'e.�K�.JI L�4 �t�I lp�C <br /> Eledncal Coniraclof Mail Addm:s Gry Sfale2ip Phone <br /> "��2�'_,.�►�1�-b,0�t��-D U 350�� <br /> S�ate Licensa Number Contrad Pnce of Wor1c <br /> `3�,� 3��N�,� Au�L. <br /> Propased Use of Building Con�act Person (Plan Review) <br /> Descnption of Work to Be Done: _CI RCU�._C �OIQ 3'"'�p� ��/�j'�11�� <br /> NOTE: WIRINV I� NON•DWELLINGS IS REQUIR[D TO FEE <br /> 86 IN R,4CEWAYS, MC OR AC CAB�E. <br /> CITY OF EVERETi LOCAL SALES TAX CODE IS 3�05 <br /> I her�by ce�i(y that I heve read and exnmined fhis applica!ion and know f/�s samo to be Gue and <br /> correct All provisrons ofl�ws snd arr,+inants goveming fh�s type of wodc v:il1 Lo COmpfetpd <br /> �vhofharspenfiod haroin or r,ot The gran4ng o!a p�+rmd does nof pmcume lo pive auflror�ty fo <br /> vio/afo oi cancol fhe p�ovisions oI any olhor stato or local raw regulating con,(nictren or fhe <br /> peAormence oI conswc(/on. Thal/am eu(honzetl by fhe owne�o�thfs propnMy ro peAorm fhe <br /> �vork lor which sppli[ation is maCe and I cump/y witA fhe Stefc Contrsaors Lsa� �t3.27 RCW snd <br /> 29b.200 WAC. <br /> �`�1�� <br /> Si nalure Data <br /> L �,�Ulh(1 � �:�7�� <br />