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�LEC7RICAL PERMIT APP�ICATION� <br />CITY OF EVERETT PERMIT SERVICES <br />32a0 CEDAR STREET, FVEREiT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 -www•everettwa.org <br />ppPLiCAT10NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />y _i �- ��3 <br />� , 3p ci —I ► "� <br />Z S( 0 7M�-�+-�'�R- K�/� <br />PROJECT ADqRESS <br />, _ _ . . _ _. � _ ...�f. � � A.�� F�v o�r C.��k yezP, �L� _17s • <br />Mail Addfe65 <br />CUy <br />S1nte2tp <br />vnonc <br />NcA- owsm ��c.uP,�.,.t� <br />MallAddtrss City StaM/7_ip Phonc <br />Tenant _ <br />. Er�—z,,-rr� � <br />� <br />_ _ _ Mail Addrr_4s _ _, _ _ <br />�oP� t�P 8 S 1- �'S <br />Slato Llcanse Numt�er <br />�i � <br />Propoycd Use of Bullding <br />� <br />� <br />-S118 <br />_..._.._CtlY_.. .. � Sfn�efLq,_.- . '.-Phone_._.. <br />�ol� <br />Squore Footngo (If resi�ential nev� �nsuuction, remodel or add�on) <br />Z-% LG�; � <br />Corrirad Prico M WoAc <br />�yJ � r,rG1_1 ----- <br />Sl.l.�-�� <br />Contad Pcrnan (Plan Roviow) <br />DoscrlpNo� of V�brk tu �c Qona: _� rcl+r-r� ��N--^� CJ C�I f2s ti Gt__- <br />NOTE: BERN f2ACEWAYS MC OR AC CACi EUIRED l'O <br />CfTY OF EVERETT LOCAL SALE3 7AX CODE IS 3105 <br /><:ar,r,c1. AU pmvision s o� ws nn � rtlinaiir.ed pnvomm�d thlv fype of work vnll bo complet� and <br />,nhelher spncfiud herorn or not Thv pn• nttnr� of a pennd dru�� not res�nx� to gNc au7honry to <br />viofofo orcont:el the prnvisions ol anY other stale or focal Inw myuPtln� cvns6vcBon or tAr- <br />pertormancc of r,onstNr•tion. ThN� f arn duthorizod by H)c ntMr.� o/fhls `�r.�poRy to porform tho <br />�vork for whfch applica6on fs mode ard 1 canply wrlh the Stnte Confrac(nrs Law 18.27 RCW ond <br />:96.T.00 INAC. <br />_�� A�G�� <br />�_ r/ --- <br />� �ignature � <br />� <br />FEE <br />-�5 °`' <br />tl3o� - i l � <br />