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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425•257-8857 - www.everettwa.org <br />��I � <br />� 5 2nd A�Jr GVF(2-�-T'T _ <br />PROJECT ADnRFSs <br />(, �U ��S <br />G ►S� 6 -06 � <br />v � t�l L C �� ciC;G7_i <br />LA�iC �4t-�lJ��;IJTI-1 �ii ��t.1`-[T-'YJl!�1... �%A27r..,�h� �.-��SZ15 �honC <br />Owne� tdad AAtlress City Sia�c2p <br />r�C�l.� l�`il-i "CC: CL e-J� f- e-JN� � L �A�u�Jj\`!' (�C7v�S L`� L1.i l i� 1 il.! <br />1 ���' � ^ SIa1CIL Phone <br />Tenant Nail AaAmss ��N � ^ <br />y=> h t�.rif.f C. 1�i <br />/� �J / %�.'O ��' f � �i c� ZZ <br />C! . f y"'/�.1. CC�t D��'\ I FCYAC� �L'V��'F' PL �J'��n l.Lb� W. iJ J <br />� � Pho�e <br />Elednc2l Contradot Mail PE�m,s �'�Y S�i�P�Z�p <br />CC iI-C>ACi lGO`����� <br />State I.icense Number (reryurted) <br />Proposed Use af Buddmg <br />Square Pootage pl residential new constmction, remoael or addd�on) <br />Number of devices (Il low vollage) <br />�2`_i.�l C l <br />Ciry of Fvcrcit Business license fJumber (reawreA) <br />y'jlo0 <br />Contract Pnce of Work <br />-t-y �,P_t�.�tJ �2��3���49 ,-Salvl <br />Contact PersonlContact NumbedFinad <br />Descr�ption oi Work to Be Done- �uAp P�A-r-->�C_ '1Y�-��(� O� �` ��'� P�'�f' <br />C,��.4J;�cCL �Or�Y�� S_LTL_(d� I�eC,a ��PCc��iC� f=�Y� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />1 hereby ceR�ty fhal l have read and oxnmined Ihrs applicahon and know thr, same lo br. Irue and <br />r.onr.cl All Provisions ot laws and ordmanr.es govemmg tlus type o! work wdl be completeA <br />whelher spen/�rd hcrcin or nnt iho granfmy ol a pnrmd docs no( presumc fo g�ve aufhonty lo <br />v�olate or Canccl fhc p�owsions ol any olhr.r sfoto o�lor.al lnw regidahng r,onshur,lion nr Ure <br />peAomtance of r,onstruc(ion Thal I am aufhonzed Ay the owncr o� fhis p�opr.rrylo perfo�m Ihc <br />worN lor whmh app��c�hon is rnuda and 1 rnmpty wilh fhe Sfafe Confrnclors Law 78.27 RCW end <br />796 200 WAC <br />nlVq,fDn0.Ui:ni� _— _--_—___ ___'—_____ ._'__ ._—____._._'—.—___ _ <br />FEE --- ---- <br />��- 30 <br />VERMIT# <br />E I �D �-(�(�$ <br />