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• <br />n <br />� <br />ELECTRICpL �'ERMiT AF�PiLBGA�'VC�6� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STR[GT, LV[RETT, WA 987_01 5`a 5�1� <br />425-257-8810 - FAX 425-7_57 8857 - vn�✓�v evereth•�a.org <br />� i�{o s-oa� <br />j�Z� � 3�J K%JF �✓C'Y'P�'� (✓Ii /��� <br />PROJECTADDRESS <br />VGv,iY V<_!^^G�n� _/—iZ� S ��� f+✓�i �z✓rrof{- � /u7-bZ <br />Owner MadAdtlress C�ly State/Zip Phone <br />Tenant MailAdd�ess Cuy Stale/Zip <br />��f1DUS�r�c__-1�`�Zf c1�ti P��t,Ec__.IEC✓�_ �✓1� � <br />6lechicalConhaclor MadAddress Cdy Slate/Z�p <br />_�11/_1ta�J_E.c 9S7 CRE� -- -- <br />Slate I.�rnnsn Numbcr <br />Proposed Use ol E3uddiny <br />Souaro Foolage Q( residential new construclion, remodel or aAdtlion) <br />Number of devices (ii law vollapr,) <br />Phcne <br />P�one <br />1r Z$tY� <br />Conh:�rl Pri�e o1 Work — �� -- <br />�a�ol� �vLL�(.r_�-�'11_ __.. <br />Conlael Peison (Plon Rwiavq � <br />Desciiptiun ol Wark �o De Dr�ne- �C��U N� ._ p?_ 1LG7ji a_..� .��lj1r�S _(%%/�y� <br />FLE - -- -- <br />CITY OP EVERETT LOCAL SALES TAX CODE IS 3105 �F �J� <br />I he�eby certdy Ihat l have �ead and exomrneJ (his oppLcalivn anJ loto�.v Ihe same fo 6e liue .+nd _ <br />✓ <br />r.nrrer.f. A!I p�ov�sions o/ lar✓s and adinances ynverning Ihis ly�ia ol vdorlr wdl be cornplelr.d r -- -- <br />�vhcfhcr specAicd flr.rr.in or nol 1 he 9ianfing oI a penmt dor.s nof presumc to g�vc ���dhonly tu I pERf•1I 171 <br />v�olafcorr.ance(lhr, provis�onsolanyofhcrsfalcorlocallawmgulatmgconsfrucfionorthr. I r � � �r _O�� <br />perPoirnanc^ ol consGuclion. Thaf I am aulhnnzr.d by Ihe ormer o/fhrs propeify !o perlorrn fhe I t i I <br />rrork Inr which appGcafion is madc and I compty w.dh (hc Sfafc Conliar,for.; La�v 1� 2I NCW and _ __ _ ___. <br />29G 200WAC. <br />�lo� ;.�y;�r-- SYr//j! <br />s��n,w�„ o,ic <br />