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+, , , .'�14 , � �;='; ���o. 163i � <br /> , -- <br /> —- - --� _' � - <br /> EL.ECTRlCAL PERIVIIT APPLICATION <br /> CITY OF EVERETT PERMlT SERVICES <br /> 32U0 CEDAR STREET, FV[RETT, WA 9t3201 <br /> 425-25'-8810 FAX 925-257-8857 – wtitiv�.everethva.ory <br /> i <br /> PROJECT ADDRESS <br /> G+'�s1�L-� �(' ;,�i"1 {�'i�J �Z( IU�� Q��e—�2iL�, W�t-��"r,CJa— �rZ.� 1fi�; • fJn2� <br /> Owner `.�a;l Acd�ess G!y Stala2�p +hcne <br /> 7snani 61a�1 pcCr�ss ` Gry Slato2p vncrc <br /> ` , �(ZJ Z�Z � <br /> C��.��/_�Nl; ,: ,,v�.T��c�►— �•c � yUN �% �,;�lc�,, W�q, �tR2�'Z--�tY�� <br /> Electcc�l Cnnlrar.tor :��I r.dtlrc_�, Ci�- Slate/Z�p Fnsre <br /> l�C-sH- ysoa-� oi ��� 5' _ <br /> S�ste License Number(recuiied) Ciry of�verett Husiness License Number(required) <br /> Prop�' � � �CIl7 , cc — I <br /> s2 0(HullrJing Co^tract Price of Work <br /> �n,iv -g,�.,,,��J '-IZS� "L�2 YY�Z <br /> � ���L r-.cfl�,f�u�. ('h.� <br /> Sq�are Fo:,IByc (If residonlral new conslruchen, remoJd ur addtion) Cunt�N Pr.rsoMConWCt �vmbudcmau <br /> � <br /> I ^aumber of deJcos pf loa�voitage) <br /> Description o(Work ta Be DonC: I'VS���/��(� .Vt'�e�_��� 7��/�. �-�V � <br /> � ���v��.���_ _ _ _ <br /> IFtt <br /> I CITY O� FVEREiI LUCAL SAL[S TNC CODE IS 31U5 �D Q�a I <br /> � <br /> l heroby certily fhnf 1 havr�ead anU examined(his eppliCafion and know fhe same fc be fr��e and __. ,_ . <br /> r.nirer.L All prov%sions ollaws and ordinEnCes go��eming lhis fype of work wl11 Oc tomplofed ---� - <br /> whe7her spr�cified hereln or noL The yranGny o/a permif rloes nof pre5ume to give aufho��ry 10 p[Rhtl I�# <br /> v.�olale cr cance!fhC provisions of any olher slate or lotal law reyulafir,q construr.hon or Ihe � I � I ' /^ � <br /> pedormnnce ol corslrucbon. Thal 1 nm pulhorrred by fhe owre�07(his proFer}y lo ped0�m thv ( U � <br /> in�crk/o;wh�r.h appUce�lon Is m,ade anJ I comply wrth!he Slafc Cpnf�Dcfors Law 1A.27 RCW artl _____ <br /> Z9ti. 00 �A <br /> �i` s�;� tu�o � ��/�Daie � --�— I <br /> Icr�^SEDOi�^OIJ .— _— —. � <br />