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�i. 3Gc.� P 't <br /> ��.. � <br /> �an. i i. 2014 12 29P•�1 �-- -- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERE'-T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8H'10 - FAX 925-�57-8857—www_everettwa.org <br /> 1 _ f � _ I `I <br /> C iuo (- o�i � <br /> '1`630 T,wnl�' N�I l s�ZL <br /> F'ROJECT ADDRESS <br /> 1� T�v��/}ea' �\�l c �1�— �ve.'lA�l c LkA c1420 7 <br /> �P1/11/�Oi' 1(�-� ���/ �N Slatc2p Phonc <br /> Owne� Mnil Addms6 <br /> S�^„� $t31n/TJp 7�One <br /> I Tenanl <br /> Mail Address �"Y <br /> I L�uC SbD � •U-�cuv� St" V�cati� u� �I��a� <br /> S a-l�a.� � �,,� S�aV�vp �ho,e aa- <br /> EIOd���Ca�Gonhador ldailAdtlmes uZ�-Zfy <br /> �S K� C�Sc-i °t3c�P--�= I SSC�D °�— <br /> Conlract Pnoe of WorK <br /> Slata License Number <br /> S���- �� -����,�,�. <br /> o��ri r�— .�_---- <br /> � D�I� �— Contatt Gerson (Plan Rovww) <br /> Praposed Use ot DuiltllnQ '' <br /> SQuare Footage(11 rrsidant�a�new canswalon,remotlel or adtl�tian) I <br /> Number oF tlevltes(If low voitage) <br /> Description of Work to Bo Doiw: <br /> .'{�,q I ac� ac�-o �u.t� �Or�2�' ��( V�-' <br /> FE�I� <br /> CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 �5 v <br /> 1 herc6y certily fhaf 1 have read und exomined(hls epplrcafion and know(he sumc lo Ae frve nnd <br /> cortecl, All prvv�s�ons ollaws xnd nNlnances gnvoming this typ�o��+'o���l1 A�eomplofod <br /> wholner spedled herrin or noL 7ho gnnfing o!a permit tloes nol presume fo givo authonry fo PERMITli <br /> violafc orconcel fhe pivvisionsThet 1 nm'nidhon cU Dy flto/ow o�of tbis propeRy ffo Dedorm fhe E I � 0 ( - n q� <br /> peAom�ance olconsWc6on. <br /> �tivrk!or w�lcb application is mede and 1 cbmpty with Iho StaM Conlrecrors 1-ew 78.27 RGW and <br /> 296.200 WAC. <br /> J�-- I 1� I '-f' <br /> — � <br /> — Signalwe <br /> �--- <br /> Fev�uo.rnvi� ' <br />