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�—_'_ — _ '— — _.—__ --"_ .' _ __— _ _—____'"_"—_ . _ <br /> i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, GVERETT, WA 98201 � �q,�/� <br /> 425-257-8610 - FAX 425-257-8857 -v,nvw everettwa.org <br /> G I30�1 -D� <br /> ��O U� e�J ILicyq�. �t. CUeXe� W14 Qg�3 <br /> PROJECT ADDRESS <br /> ��� �la;v�es 4z.o- z3�-�i��g <br /> O�vner Mad Adtlress CAy StalelZlp Phone <br /> � <br /> Tenanl M11ail Address Ciry StatMLp Phone <br /> �U�i-TEc-N E�FC.T�21�F11_. SE�vtLES P�c9.aoK Z�{$5 �,..1�<Qthv��\� �- `i$d'�Z <br /> Electrical Coniractor tdad Address City Statel2ip Phone <br /> I � <br /> V��TTES3�tZDv. � Z � ��v � <br /> State License Number Conlract Price of Work i <br /> �'es �c� cK-��,�1.` VIa�.Q ; <br /> Proposed Use of Bwl�ing Conla=t Person (Plan Revievq <br /> y, ?c� �, -�4 <br /> Squ2r— e��ge (If residenti�I new construction. remodel or addition) <br /> �x <br /> Number of devices(If low voltage) I <br /> Descriplion of Work l0 6e Done: _Cp�tLC �? — w� � �.._� e� � ���� S— ""' �� <br /> �(� J <br /> � I „�c - Vulk_�_ 4v�c%C�.� -S �ros+.�c� f�o1 AI,A�v✓ �LZ ' <br /> � I-,V/�-C in.?�1 �-�L — — <br /> I i <br /> FEE � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS a105 I �OG <br /> 1 hereby certily that 1 have mad and examined fhis applicafion and krroiv fhe same fo be fnie and <br /> conecf. All provisions o/l��vs anJ oNinances�oveming this type ol u�ork will be compleled <br /> �vhethcr speafied hc rein ornoL Thc gran(ing o/a pem�it docs not presume fo yive autlront}�to PERMIT# <br /> violafe orcancel fhe provisions of any other s1ale orlocal la�v regulaling consfiuclion or fhe r I 3O� ' �1�� <br /> pedomiance ol constn�cfion. Tha(I am a�lhonzed by fhe onner ollhis pmperty to pedomi llm C V <br /> n�oik for ��iich applicafion is made and 1 cornply wilh(he Slafe Confractors Lmv 78.27 RCIN and <br /> 296 0 AC, <br /> S� -� / �c / 2�� � <br /> � Signatu � Da1e <br /> tiEY5�O1Yn�r3 --- ._ � <br /> I--_—_—_. . .___. ____— --- __ <br />