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� ELECTRICAL PERMIT APPLICATInN <br /> I <br /> CITY OF EVERE i7'T PERMIT SERVICES <br /> 3200 CEDAR STRF[T, EVERETT, WA 98201 <br /> 425-257-88�0 - FAX 425-257-8857—t�nvw,everetiwa.org s_ �C? � ( � <br /> � c�u� s-�� u <br /> 2�� 2Z c�l b 5•...;-�-� Z� c7 ' <br /> i'ROJECTADDRESS �¢r(L � �g� <br /> /1/r•.�J ��/vn�.}� L� �+ LS�S <br /> L8'L� i�ke,-[� E-���- WA�, 5 �1�\ og3a <br /> Owner � 1.1a'dntlaMss C��y� Statef2ip Phone <br /> sn oh o..,.;rl� ��...,� �is) '�34 <br /> �..�1,�� fl��..,.�.�5- I��-1 ���;� ��-r1�r ��' l,�-� � �?� I ,S3o-o <br /> Tt]nanl MailAddress" �""�"� Gty SW�eIZip Fhonc <br /> � ^ '( �(�,�r l� '�� I a. w� ��'�3�� <br /> FSIt-�—�, � Gotiw�u�+.;�wT�,na- 3 l'� I11, �{� �� ��t�U� /n 1� <br /> [Iedi�CalConlractor L1allAdtlm�.: CiN Slate/ZIp7 {3� ationc <br /> �-�.[_PN �S a�6t�} �5 aoo <br /> Stale Licensa NumDer Con;ract Pn e of Wprk i <br /> ��:G2 S�Gt� <br /> Pwposed Usa ol Bu Ing ^� Contact Porson (Pl�n ReviCw� <br /> SqU3fC FOOtage (if resi4Rnlial n@w COOSINCliOn,10motl0�Or 80dI11C11) <br /> INumber cf devices(If lo� <br /> IDescrlpilon of Worl:lo Bc Uona� �twJ� �--d-� �� ���,,,,�„� C,�j I� �� �`_ � <br /> � _�� �C"r�$' . <br /> FEG <br /> CfTY OF FVERETT LOCAL S/11_ES TAX COD[IS 3105 J � r j� <br /> E�f '"/lJ I <br /> I hpreby Ccrfily th�f I havo R nd Ond r.xaminod Ihl,appliColion and Imow fhC SemC f0 be fruo and <br /> r.nn��t. All pibvisions ollawc and nrtiinances gov�minp thiS type ol w�rk wlll bC Complefed -�- <br /> �� �vhnflrrmr�pr.tiCeJ hemm or not, Th_^yrrmfin�ol a pennif dw:s not pmsUme 10 give aulhonty fo PFRMIT" <br /> vmiate or concr.�fne prov�a�ons ol oay othcr sfato or locol law icyWariny consfruclion or(ha „ , / l <br /> P�dOmidliCC 0/const/ucho�. T714f/Om aulhontBd by Ih8 ownB�of IhiS p10p�lty IO pCdaml Iho ��'t� I <br /> woilr lor which apPlica6on is rrmde anA I compfy w)fh Ihe Sfnle Conlrec�ors Low 1 A 27 RCW and � � ��� � � J <br /> 296.200 W�C. — -- <br /> I � � s r6 ' y , <br /> S�gna!urc oato <br /> I I <br /> urvr:CDaa�rl <br /> L'�__ <br /> _'�_ �� I <br /> ._'�_" _� �� <br />