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__ � � - <br /> _ __—_ _ -- ___ _ <br /> ' ELECTRICAL PE�RMIT OaPPLICAi"fON I <br /> ' CITY OF EVERETT PERMIT SERVICES i <br /> ' 3200 C�DAR STREET, EVERETT, N/A 98201 <br /> ! 425-257-8810 - FAX 425-257-8857 — vnvw everettwa org <br /> � ���� � �D� �'�' S� ,���e� �i/i''- <br /> PROJECT ADDRESS � ��',�/✓ <br /> 1 G C « i, �•r'�� ��,� _ 9i9 <br /> i�f v _�_ _ hl����z1z- ___��`� .-� �-�—_�v� s� �v�'�/, ��: �r'�.��� �i o s <br /> Guner �ti1ad Atlaress Gty . State.�Lp Pr,cne � <br /> — i <br /> Tenani Ma��lACtlress C�Iv State�Zip Phone i <br /> � �c �- �f"% ' ?y>- 9i7y <br /> � �/i//`<L�� �G�iS/.G't Tc._-_—.���/ � _ Z. / � � l /�—�� j <br /> �'�` ����.�l �z . r(�r�'t' � I <br /> ,, _!e^�nCalCon;racter t.la:lAdd;ess C�ry Slale�Zip l-/� Phvne � <br /> � r � ��� � //C � ��_�c� <br /> �.�Gffl���;S- 9/7G•y �/G=�.s ?v <br /> State License ��umber Coniract Pnce of Work � <br /> ��r/��lCcn <br /> IProposed Use of Budding Contact Person (Plan Rewevq <br /> Syuare Foolage p(residenhal ne�•�conslruclion, remodel or addd�an) <br /> � I�lumber of devices (tl low vol�age) <br /> �i,J <br /> ' Uescnpiion of Work to �e Done FL%rrc <' �![ ScU G���'L �%l��/�o c• U, i �. __ ,_ ,, <br /> I�0/f'—J�('i�t7<< ��iCc�i �i/+"/ <br /> � - - <br /> i --— — ---— ---- --� ----- ------ ' <br /> FEE <br /> i CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 � ���\ I <br /> i l hereby certdy thaf I Irave read and exanunod fhis apphcation and know fhe same to he bue and <br /> 7 `� <br /> conec! A!I prov�sions ol la���s and ortlmances qovemm�fhis fype ol work will be conrplefed — I <br /> in�helher specrlied herein ornoL The granhng o/a pennrf does no(presume (o give autho�ih�fo pERh1IT; ! <br /> �:�ol�te orcancel fhe prov�sions alany a(hersla(e orlocal iaiv reg�dating consWction orlhc E I�D I � ( �S � �� <br /> pedormance u/consln�c(ion. 7haf I am authonzed by(he onv�erol(his,�ioperty(o pedorm the <br /> �,�vrk�or�vhich appOcafion is made and 1 comply��nfh the Slafe Con(racfors Law 18.27 RCW and I <br /> �P6.200 WAC <br /> � Gr.1_���"_' �'�GGG`f/�'✓"i Li�4-��vi✓`_'��':.— �j�G� _��/ <br /> Signa ure� �—�- Da!e 7 i <br /> � . _ i <br /> i <br /> Fe_�.. ,.,; � <br /> __ _.--------- - - --.__. .----__. .- - - -- ---- --�----------- -- � <br />