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� � <br /> ELECTRICAL RERMIT APPLICATION <br /> CIT`� OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,.WA 98201 <br /> 425-257-8810 - FAX 423-257-8857 — www.everettwa.org <br /> �—Ib-►S <br /> E � s05-d°� <br /> /D �D �Y�e,c.i���, ��.�X <br /> PROJECT ADDRESS <br /> J t 'c �uo a .�..cC �v 9D� - T�"'Q i4✓r. [,� �.r,o..,ns 9��.L _ <br /> Owner Mail Address Ciry StalelZip F�ione <br /> F,esr N�"i�.v.ac .4u�a i ia 6 30 �vf.¢b�°�.v Wf►�fvE.Ce.rr 4��0 5� <br /> Tenant Mail Address Ci1y <br /> State/Zip Phone <br /> X�S <br /> ��uMB �ilpvs 909 .5 ad'L.S� r.4r�.�r, 9dyo9 �s.��-s���.�� <br /> Stale2ip Phone <br /> Electrical Coniracto� Mail Address �'ty <br /> T.LLI n76ro'f�VT/ 7� '5��•�p S <br /> Stale�icense Number(reqwred) Ciry of Everett Business License Number(required) <br /> �soo <br /> �L� ���s C Contracl Price ot Work <br /> Proposed Use o(Building r <br /> Co iv�v�L lr+v fF� <br /> o1.s3 • '�7.3• 3�33 x�S <br /> Square Foolage pf residential new construction, remodel or addition) ��a���L�C�� N�d�ai�N3•Ce w.� <br /> � <br /> Number oi devices (If low voltage) <br /> Description oi Work to Be Done. <br /> /O�aOIG U� I�� l��"LL �/G�t/�_!< <L,� <br /> C/L�tSTiy.�.�7. �..iG �i:r.� v� E K�Sr��ub� /`�O'tv t�C• <br /> ��b�v c� .2,¢u .� .�Y arrt-t-�: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES iAX CODE!S 3105 SO�� <br /> I herr.by cr.rtily thaf I have read and exarnrned ffris applicafion and know the same fo Ge We and _ <br /> conect. All p�ovisions o/laws and ordinances goveminq this type ol work wi/l be romplefed <br /> wliefher specified herein or noL The granting o/a pemuf does not presume to give aufhonty fo PERMIT# <br /> violate or cancel fhe provisions ol any other sfafe or local law regedating const�uction or Ihe C <br /> pedomiance of consfnicfion. Thaf!am aufhonzed by fhn, owner ol fhis property fo peAoRn the `1 5 O S � �� <br /> work lor which app6cation is made and 1 comply with the Stafe Cont�acfors La�v 78.27 RCW and <br /> 296 200 WAC. <br /> . D � � .50.��•�S <br /> SignaWre <br /> r Date <br /> PEwSEOnnmsnoiu -__ _ <br />