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03/07/2019 00 . 20 tl4:63 P 001/001 <br /> � ELECTR��AL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEpAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> 3 �7-�`� <br /> j C �403 -033 <br /> a�•� ! Z�.. I? IJC,�Irll .�l/� <br /> PROJECT ADDRESS <br /> ��� U��'�.�:7 W�� � /}'/� <br /> Owi�ri Mail Aatlre.s Ciry Stale/Zip , Phona <br /> —Lj�� r %P t �cc , � r'`l�R� . <br /> Tenam MailAddress c�� Statellip anone <br /> ��L(��I�G1� fr,!' �C P3�� I`l���> C�-G ��.?�''� <br /> Elecincal Contraaor r.taii nuams> ' Ciry Staio2iv Pnone <br /> 1E1't-A��v�SI/y 21'.� �� ^ <br /> Stale License Number Contract Price o1 Wotk <br /> � P��c�/�li�_ - <br /> Proposca use o1 wmmg , Contact Person (Plan Revi��v) <br /> Square Footagn pt rusidential new construction, remodel or adtl�t�on) <br /> Number ol devices(If iow voltage) <br /> Descnpuon o(Work to 6e Done: �ltee�i� G(/? [�v[��9T�—r!/Z �, T�'��_ <br /> �_�`dy� <br /> __'__— � �l �(� �..--�� f L /��!8+�/� <br /> FEE � � <br /> CITY OF FVERkTf LOCAL SALES 7AX CODE i5 3105 /'� <br /> v <br /> I hereby r.oiiify lhaf!hxvr. mnd und ox,rnlnoa m�s nppncauon and know Iho sumu(o be m�c antl <br /> cnrrocL All provisions ol laws and orcllnences yovnrning M!s fypo o(work will bo complofeU � <br /> whefhcr spod(od horoin or not. Tne granfin�o!a pennif dous not prosumc ro yrve eutAnnry to pFRMIT# � <br /> violate or cnocci�hK provis�ons ol any o�ner srnre orloeal law roguio�ing constnletion or the :.i:� <br /> podormance o/cons nic6on. That!nm oufhaizetl Gy tAo owner o/this property to pedUm�(ho E I �U j _O��� � <br /> work foi which ap .atron is mnUu anrl I comply w�th�ho Sfato Conhac�or�Lnw 18.27 RCW ond � <br /> 296,200 WAC. � <br /> � �� � 3�� � <br /> , , �� <br /> a i:[o a2m» <br /> .__._ — .__.�_—__ ._� <br />