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osioaizoi5 oa zs <br />reezs P ooiioo2 <br />ELECTRICAL PERMIT APPLICATION <br />,�Q Z <br />PROJECT ADDRE55 <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREEf. EVERET7, WA 98201 <br />42rr257-8810 - FAX 425257�857 - www.everettwa.org <br />�l MD�9- Si9oA/d t SD2 fiLtD�2iP � �G�/ <br />ownor naa adaress cxr su�ezv w,o�� <br />Tennnt <br />l�1 <br />Me�l AtlGross <br />Electrltal ConU2dut Mai Addre%s <br />f� �''Lft�UfS > yZ.U' <br />Stalx License Numbcr (roquitatl) <br />��� <br />Proposed Use ot BuilOing <br />Sp�are Foompo (If resitlentisl now consWction, mmoEol or addifion) <br />Numbor o� tloviras (M Inw voltage) <br />Dr.�npUon of woik te Be Done: <br />� > <br />i <br />V /�t'� i � <br />CIIY OF EVCR[lT LOCAL SALtS TwX COD[ �S 31J5 <br />GA' <br />Cily <br />statxr4p Pnono <br />� �'� 2✓� <br />s�s�rr�a � <br />a /4.YG � <br />Ciry ef Evorett usimss Licensx NumDor (roquirea) <br />Ic�h / 41� :titr�� t7'�� <br />Ccrttnct Pnce ot wortc <br />Con�c1 PersoNContacl NumboUEmail <br />� <br />1 hereby cwrtily fhat ! havo read and xxaninod wis app6caUon arrd know (ho somo fo bo We antl <br />corrad. All provisinns ollows and orrhnencas povominp Nis fypx ol wnifr will Ao mmplofod <br />wholho� apeufixd herr�in or noL The grnnGnp ol q pemvf dn95 rrol presw nx fo piMe auNo�ty �o <br />NM7fe or tan[91 H/e prrnnti0n9 of ary oVlnr slxfn or Incnf lew rogulatlng oDnsinitllon or Iho <br />poAamiance o! nznuaion. Tnai 1 am eirtnorrma ny rne ownor o� mis �mperry ro p�Aamr r�e <br />work lo� whichp�plicnhcvi is mndo nnd I mmpty wifh �ho Stoto Conbaclnr.s Law 18.?7 RCW �nd <br />29fl200 WA(Y%% <br />r /� <br />/ <br />Dato <br />oeoc�m� <br />FEE ��c <br />� <br />PERMIf# <br />E15b�-02� <br />