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ELECTRICAL PERMIT APPLICATION I <br /> CITY OF EVERETT PERMIT SERVICES I <br /> 3200 CEDAR STREE-T, EVERETT, WA 98201 <br /> 425-257-8810 - �AX 425•257-8857—www.everetiwa.org ��, <br /> �(��-30— <br /> � �� �4iv-��•� <br /> 9a <br /> 6oi6 Se.�„� I� A �� �=.,��k-� w� w�,#- � <br /> PROJECT ADDRESS <br /> �-��_�O�i Z. <br /> ,�,� s1�«k�r-i' t9�26 1�3c-�,1, s-� se Mo�ra` �v.�y9�.iL <br /> Owner Mad A40r9fs C�ry Suie2p pno�e <br /> Tenani Ma�l AtlCresS GIY $lata2ip P�onn <br /> Ele[ViCal ConVattor ldail AOAress Gry Slate2ip cnone <br /> i <br /> SUto license Number(reqwredl Gty ot Evemtl Business L�cense NumGer(require0) � <br /> Q� ir�v��'�-�-� <br /> Prop���tl Usa of Bu�lding CaNtact Pncc ol Work <br /> J�-��� �a�/��.-s��%,z.� <br /> Sauare Foo�age pl rc:itlenliai new constructir,n,remodel o�additlon) Contacl PersoruCordact Num}M,�dEmail�y� <br /> J I J(-�,jjti�n��c0(r th <br /> Number ol devlces(If low voltagc) <br /> Descnption ol Work lo Be Dono. �)��{�' / "V�i i� � �Hc_-j'( �c.c� I �_��� <br /> I <br /> � <br /> GfTY OF EVERETT LUCAL S4LE5 TFJ(COOE IS J705 � r <br /> 1 he�vby cerfity Ihaf I h.ve roatl and eramined fh�s appLco(mn ond know Inu same fo De We ontl '-� <br /> co;rccl. All provisions cllaws and oNinances goveming this typo o/work will Ge completed <br /> whetAer speci(ed horein or noL The gr&nting ol a permR does not presume fo give aufhonry to PERMiTA <br /> N��lele or concol tno pr.vrsions o/eny olhor srole or local lew iogulefing canstrucfion or the <br /> pedomianco o/conslr�clion. Thal I om eufhonmd Gy fha owner ollAis property to pedorm Iho E 'y(D , �G�� <br /> wonr fo�rh�cM1 app6calion is m�dc end!comply wilh tho Stafo Confrectors Law 7g 27 RCW and <br /> 296.200 W9� / <br /> � <br /> .-�-=� �� l 0�2 9 / y <br /> Signaivre ✓ Uatc ' ° <br /> acv�oasav�oi. <br />