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� ELECTRICAL PERMIT ��PPLiCA�ION <br /> CITY OF EVERETT F'ERMIT SERVICES � <br /> � 3200 CGDAR STREET, EVERETT, WA 98201 <br /> I 425-257-8810 - FAX 425-257-8857 -vdvn^�.everettwa.org <br /> L�SiD�I bz- <br /> / 0—'ao_� S <br /> �7 2 I S'r`� A,,m l-.� <br /> PROJECT ADDRESS <br /> �hp,,,i.s Lo..,r� Sy2� �' A� Ey_e.c� w.4 �i$?� N <br /> Ovrner Ma�,lAddress Ci�y SlatelZip Phone <br /> � <br /> Tenanl Aiail Atldress Ciiy StalclZip Phone <br /> �«..�- it�e�;�, 4 �v�LIL 23�06 7'�, Ave� x SFe. � �.11 l�`����- <br /> Electrical Coniraclo� Ltail Address City Slate2ip Phore <br /> -�D � , ��L� 55/�� � �2� K�-l0000 <br /> 1-�oP,EL25g83 DCa /� 3g _ <br /> S�a;e Licenae Number (required) City of f_verett L�usiness License NumGer(requireA) <br /> s�� _ug�Q. -- <br /> Proposed Use o(�uildiny Ccnlracl Price of'Nork <br /> I kZ5- N8�- l�00"� — <br /> SGuare Faofaye(If residential new mnstruclion, remedel or addition) Conlact Person,'Contact NurnbedFinail <br /> Number ot devices(I(lov�vollage) <br /> Description of Work to f3e f)one: �iooi" r_hq�h.'�'ep� /• $�r k V ����Y�K�-�_ <br /> �ke.k 2SU�,J WaG���S ��..�Lnnp-_—�1L���_7�0 n _-1�i l �-�_ �n.kL�.c� <br /> FE[ <br /> CITY OF EVERETT LOCAL SAL[S TAX CODE IS 3105 � v-� O 1 U"/ <br /> J <br /> 1 he�chy caiily that I havc re�d and exarnined(his application and knn�v the same fa be Vuc and _ <br /> conecL �lll p�ovisions o/lmus�md orJinances goveining this(ype o(:vork viiHGe complefr.d ----� ---- <br /> �vhetherspeci�ed he«3in ornoL ihr, giantin�o/a pem�it does aof presumc�(o give autliaity to PERf�iCi// <br /> violale or canr.el fho provisions o(any other s(afe o�local la�v�egulnGng constn�clion oi fhe � I��O I 1 r� <br /> perlominnco ol conslrucfion. That I arn aufhoiized by(he o�vner o/fhis pioperty to pe�lomi(he � �y L <br /> �:urk lor�vhir.h application is made and/compty with Ihe Stafe Conlracfors Law 18.27 RCW and <br /> 296200 bV�1C. <br /> � �� ��-��S <br /> Si a �e Uale <br /> RFViSE'D Gd9.`.?014 <br />