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�Unv. 19. 2014 e: Ohr'id No. "1929 f'. 2/2 <br /> t <br /> ELECTRICAL PERMIT A►PPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE?T, WA 98201 <br /> 425-257-8870 - FAX 425-257-8857—www.everettwa org <br /> l� --�9"��/ <br /> E��l� �-l/3 <br /> I.�U la, . '�� �v.e- S� <br /> PROJEC7ADU SS <br /> �{Q�-4�ta� I l� (� `� �Fue s� �exet�, <<,�a- �.�za � 4�t-�H3 kNr� <br /> OWn9r Mall ACdress City Slats/Zip Phone. <br /> Tenan( MallAddress City SlalrJ7_ip Phone <br /> � 4fna��Ne �� � ��.Inav� e�-��n� lA�r Si�i.'� z UtS•LSL-tikn� <br /> EleclricalContraclo�—�tdauaadress Gry stetertip ahone <br /> F�S��r�,s+-�,o�< <br /> Slate License Number(required) Cih;of Evereri Business License Num6or poquirod) <br /> �r S�cl�ean-�i —�Q�-- <br /> ' Propo50d Use ol Buitding � , � . ConUact Ptite pf Work • <br /> {��1[,LCU/1 �rtx� G�ttwvt �tC�uackirs, ayvl <br /> Square Footage Qf residenlial new const�uction remodel or adtlltion) ConWct PersoNContnct Number/Email <br /> Number of devices(If low valtage) <br /> Deseripuon of Work ro Be Done: �P�U F� .Q�Q �_���Q����A_ ���n�T <br /> F[[ <br /> CITY OF EVEREiT IOCAL SALES TAX CUUE IS 3105 �]C �O <br /> 1 hereGy certily that 1 have read and examined Ihls applicafion anU knowlhe samo fo Do truo and � `� <br /> conect. All provisions o!laws and o�tlinances govomina tAis typo ol work wilf 6e crompleted - <br /> wheUrer specl�ed herem or nof Tho gr.�ntin,q o1 a pormit does not prnsume(o pive authonry to PERMIT?I <br /> violafe a cance!(he provi,ions of any ofhor sfate or focal law regulr�llnq conslruclion or Iho � I � r 1 I _ I ( � <br /> poAormance ol conshucGon. Thaf I am aufhonred by!be ovmvr ollhis property fo podunn G�e Ll, � I <br /> woric lor Which ap iicat%on rS mode nnd I comply wilh(he Stafo Confracfors L�w 18.27 RCW anU � <br /> 796 200 WA <br /> � � I I �, /1�-/ <br /> Slqnatme Oate <br /> PEVISE0449Q^JII <br />