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� � <br /> ,- -- <br /> -- -- --- - - - _ _- – --- — <br /> — - ----� <br /> � E�ECTRIC/�L P�RMiT APP�.YCA�"�C��I <br /> � CITY OF EVERETT PERMIT SERVICES i <br /> i 3200 CEDAR STREE i, E�/ERETT, N/A 98201 <br /> � 425-257-8810 - �AX 425-257 8857 - �:,,m� everetivaa.ory <br /> I <br /> C �` `I I � <br /> _ I � 1 Z `f C)�� J"1 _ �.v v v Q-�i \./Ll A L�`� � � ' ��'L i <br /> PROJECTADDRESS i <br /> f�o �•k�, W�-S�- �`��� �� �--�C� 31�� �4V�<2t�� �,� G�lU� �ZJ� `{� � <br /> . Cvmer MailAddress Cdy SIa1c/Zip Phone I <br /> �_ — <br /> Tenant L1ailAddre,s G�;y SlateRip Phone <br /> �25 '�y-(� OSS� <br /> j ���� Q �v-�� S�YV� ces �ti � 2(a`\1� �12`"�� t�� �� S'�v�w��� G�a�a <br /> � E�ectrical Con� ctor P:1a�i Address C�ty 5tate2p Phone <br /> i <br /> iiN i� c�- Si Sy�-N--� _ G s� �' — <br /> Slate License Number Conlract Pnce of Work � <br /> I ��es���i�n-��� � ���� �ehcc `{zS 3 `�b oSSO <br /> P�oposed Use o(Budd�ng Contact Person (Pian Revfe�v) <br /> ���� <br /> Square Footage pf resideNial nev+consiruction, remodel or adddion) <br /> I <br /> Number of devices (tl low vollage) <br /> \ 1 . <br /> S Y.� iJ o,��c;1 �.,,,,.,.. s;v,�\, ��,��,� h <br /> Description of Work to Qe Done: �' �"U� k �R��U`'� ;—7— <br /> �S�1 G�t�� �il�� �`t 1' V t,'SV•r-�._ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 � �rl� <br /> �l <br /> I hereGy certdy Ihaf I have read and ezamined ll�is applicafion and luie�.v fhe same fo be(rue and <br /> correcL All provisions olla�vs and ordinances governing this type ol work�vdl be cnmpleled <br /> whefher specr!ied herein ornoL 7he granling o/a permit does nof presume to give aufhority to PERMCT# <br /> violafe or cancel fhe provisions ol any ofhe�sfale orlccal law regula(ing conshucfion orthe � I �O�` I <br /> peAennance ol consfruction. That I am au(honzed by the o�aner o/Ihis properfy(o pedorm Ihe <br /> work/or�vhich app6cation is made and I comply with Ihe Sfafe Con(rac(o�s La�v 78.27 RCW and <br /> 296 200 VI�AC. <br /> � f�_�— � a- 1�� ti �`'�� `�' <br /> --S+�jnature oaie <br />