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� � <br /> – ------ <br /> � _ _ – – – – --- -- <br /> -- – – – � <br /> � E��CTRYCAL PERMiT AF'I��VCA�T��(�I� <br /> � <br /> i CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STR[C-T, EVERFTT, WA 98201 i <br /> 425-257-8810 - FAX 425-2�7-8857 - �'�n'nv.evereth�ra crg � �� r I _I � i <br /> C' � �((��S–l�� � <br /> � �Z� �c��,��✓S�' �v+� G�v�-l'-� ����i�2�o� I <br /> — , <br /> � PROJECT ADDRESS <br /> i /� �/� ��V/�l/} �� �� �o����'�►� �� ��Q�'�tku�3 4�s������'� <br /> � ����1� �' 1 � 'ldLLw=" CqY � SIalvZio Pacne � <br /> � v:ner A9adACdress <br /> t c,�•.a :l�hd-�,v� �2� �r a �u,��s��� i�ev��t <br /> �kZi�3 �, <br /> �,. SIaL2o Phcne <br /> � lenan� 7adAUdress � � <br /> � �"'` =1eelv� r�-�� � � _ �ltit +3 I�I St�w+� ����( � <br /> ���— -���'✓ �''�ti�o (a�e �� {�v <br /> �:,�y Siate2p Pnone I <br /> [ledrical Contiacicr fvla�i ACdress ��I C�c� � <br /> ��5 <br /> Z�L�G�."ll��-- - . �Q�,oO I <br /> Contrad Pnce ol'vJork I <br /> � Sta'e License Numbrr <br /> i .� ) ��,Lc,P l"Iltil'�S��l%� ✓ — <br /> �1.��'� `-� Contact Person (Plan F2ewew) <br /> Proposed Use of Bwid�ng <br /> Square Footage Qf residential new ccnslrucfion, remodel or adddion) <br /> L I <br /> Number ol devices (Il low voBage) <br /> ����c�, �'e.c,-IYI ������ , <br /> Descriplion of 4Vork fo �e Dane — <br /> -- --— ---- -- I <br /> f-FE <br /> � CITY OF EVERETT LOCAL SALES TAR CO�E IS J105 �� - IJ�D <br /> i I hereby cc-ddy fhaf 1 hace mad and exam�ned fh�s app��cafion and Mncw fke sarne;o be frue and <br /> icorrec7. All proNsions olla�vs anJ ordinances goveming fhis fype of�vork r+dl Ge comp�eted <br /> �vhefher spea�ied herem or nof The qranting ol a penmt docs not presume(o g�ve aufhonty to PFRh1IT# � <br /> li vlolate or cancel fhe provisinns ol any ofher state or lotal law regulabng conslruction or the r I � (/�/' ^� <br /> neAonnance o/consfnichon. 7hal i am aufhonzed by fhe o�+�ner o(fhis property to pedorm Ihe C Uvf U <br /> work!or which app6cafion�s made and 1 comply w�lh the Slafe Conlracro�s La�v 18 27 RC W and <br /> 29G 200 WAC. <br /> ��,u�� ' �'—�� -1�-- <br /> Date <br /> 9gna�ure <br />