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Aug 0515 0527a <br />ELEGTRICAL PERMIT APPLICATION <br />CITY OF EVEREn' PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425257-8810 - FAX 425-257-6857 —www.everettwa.gov <br />�-�-1 � o GK e�� � L�� <br />PROJECT ADDRESS <br />p3 <br />� _0=--15 <br />�ISa4�� <br />�-125- 3�-1l� - � <br />J O�1 Y� �-e[�� t�cJd fi 4U-1 � o �K e-�-e L(�✓ � �� -���L-�- j,�c� � k� I <br />� Owner Mail ACAms�. Ciry Sta'elZip Phone <br />I <br />i TEnant Mail AdOress Ciry Statclllp Fhone <br />LJ �5 -335 — <br />I��rsrds� w� l� Q�t.+r» � �i�-� ✓ � �, �► �`� "�`/�►�Wl�:r ysvl tl� lJc� `�v a �, <br />ElocNpl ConhaCor <br />✓�D Y C%S�1q �i � `.��.i'l <br />Stale Licerue Num�er (requireA� <br />s,�,�� �.._: �.__�� <br />Proposed � I Building <br />Square Footage (If icsidenlial new consiructlon, remodoi or adtlition) <br />I <br />Number of dences QF low valtage) <br />Oesrnption of Wark to Bc Done <br />Gy <br />Phone <br />C��I �-"7 �i <br />City of EvereR Busincss License Number (required) <br />� �. ��-��.� <br />Cenlract Pnce o( orfc <br />�h � 4 a-s-� �s- � oa� <br />Con[ad Person/Contact Nurnbcrl[m, il <br />CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br />I hr.reby cert;fy lhat I have read nnd exom�ned lhis appGcafion and kro�v tho samo fo bo (iuo r+nA <br />cortecf. All p/nvrsiorw^ olfans and ordinances uoverning fhis typo ol wo4c vnll bo completed <br />wheU�o� speci�ed hcrein or not. T1ie gr��umg o/ a pomid dces nof prssunre (o yive ouU�oriry fo <br />v�ola(c or cancal tho provisions of any ofher slafo orlocal �aw roguraLnq conslructwn or tno <br />perlonnance of constrtrd�on. Tha( ! nm aufhorrzo,N Ay tho ovmer ol thrs propoRy to poAoan tlm <br />a•ork lor �vYr 'r app/�cafion �s mado end 1 comply u•itlr thc State Ganbuctors La�v 78.27 RCW and <br />296 2C0 <br />—������ _ C) ' � —/ � <br />rt�yr.:cnuflmc^.ai+ <br />FEE � <br />� ��°0� I <br />PERMITk <br />E 1�08 `D��� <br />� � <br />