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-- - . ! - i <br /> ELECTRICAL PERMIT AF'PLICATIdafV <br /> CITY OF EVERETT AERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 , <br /> 425-257-8810 - FAX 425-257-8857 — www.everettwa.org K��(��� 3 � <br /> C���1`�� 66 'I <br /> '� aoo 4 � sr S�}e� r E��.�N , w.a qS�o� I <br /> PROJECT ADDRESS <br /> ��pp '-f � Sr 57;-«t LL/i � 5�� � is� 5 �,-�� � rvQ-�tf w.tt H �LoI �tZS q7 �1 c�Sz� <br /> Owner � Ma�l Address Cdy � Sta!e%Lc Phone �I <br /> ��-�.,t;�r L��,., ..:r :roNs I �oO � Is�- St.r�t Ev�t�i-f Wq `� 82� 1 �L� �61S5 � $ I <br /> Tenant MatlAddress Ciry State/Z�p Phone I <br /> i <br /> S��h�ly Cv,.ve..le,f Src,:+„ Sol +:..� z7uo R",�G�,t�r �� s.,�e ZoZ 3. licv�z Fl,4 9BerS 42SW5'77eoo � <br /> Electncal Coniractor � MailAdtlress Gty StaleZp Pl,one <br /> S i A N �G y H 2 Sm z I 0 , '�6 .�. �o � <br /> Stale License Number Contract Price of Work ii <br /> p ��)[ e <br /> `��;A (-ie.i` Z <br /> Proposed Use of Building Conlact Person (Plan Review) �I <br /> I <br /> Square Footage (I(residential new construclion, remodel or addition) <br /> 3`1" n�w 3Zc�..u�.r �� � <br /> Number ot devices(If low voltage) � <br /> Description af Work to �e Done: � �� S F�� /1 h e w C n�,( {-eti./�r s .�o t- c�a p� [i(t P I 5 , —�h f�a l i <br /> c��al1�C'v�;f Cov� v��r�f� O IG7 c�. c� �,(c�IS na�+°� S '+"9 �,dL s•ISTCtH . <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��)� <br /> i <br /> 1 hereby certi/y fhaf I have read and examined this application and know(he samr, to be fn�e and ___ <br /> correct. All provisions ollaws and ordinances;oveming fhis type of worlc�vill be compleled <br /> whefher speci�ed herrin ornoL The granting of a pe�nit does nof presume fo give authority(o PERMIT# <br /> violafe or cancel the pravisions ol any other state or local law regulating constiuction or the � i( _ r / � <br /> perfo�nance ol consWchon. That I am au(honzed by the o�vner ol this property fo per/orm fhe E ,3 OG� I (p <br /> work lor vihich appl�ca(ion is made and 1 comply�+�ith the S(a(e Contraclors la�.� 18 27 RCVI�and <br /> 296200 YVAC. <br /> �� � � 26 � 13 ---- <br /> Signalure Date <br />