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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT SERVICES <br /> 37.00 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.evereitwa.org 3 �� —�S <br /> G i �3--a35 <br /> I�oo i3�" S{ r_„«�+� �A 5$ Za 1 <br /> PROJECTADDRESS <br /> �RM��..Y ��00 13� '��j� CVC�c+} W� IS��� ( Y1S-2�1-2eoo � <br /> Owner MailAddress Ciry StalelZip Phone <br /> �R,uc�_ ��o� 3{�` SF G�crzk�- �h i6�ot tiz5-ul-zmo <br /> Tenanl MailAddress City S�a�eilip Pnone <br /> �i_Cr-1 ticc.ti- ,L �� t�,o�C {30`��;� SCc.�-I'�t tN�} 'f8i043 to6-K3�-Szo� <br /> Elr.etricalConiractor MailAddress Cily Stale/Zip Phone <br /> Vr Gl� �_C_i ��f 2 M U o o �(�� y � <br /> Slate License Number(required) Cily of Everett Business License Number(required) <br /> � �SC.�O. SL <br /> Proposed Use of Dcilding CoNract �rice of Work <br /> ���-eso-�-,j8 <br /> Sr�s�u �NoEa�,a,a �v <br /> Square Foolage (If residential new consiruclion, remodei or addition) Contact Person/Contact Numbed[mail <br /> Nurnber o(devices(It low voltage) <br /> Description of Work lo E3e Done� 1-� ,n �00�'L �Ow cr �..(�� �- Qi..la D�.1G G b r� _ <br /> '"Fo �002 prl �� � F-�0 o f Or S� - (.��n< .SAt.��S�� C�C. <br /> T— <br /> _GxfLn�_ C.�C�S+; � Au�o d�i c:Fu�' �',rC_�., f <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � / S� <br /> r <br /> I hereby ccrlily Ihal/havc rcad and examined fhis application and know the sarne lo be liue and __ <br /> correcL All provisinns olla:vs and ordinances governing this Ivpe ol work will Ge comple(ed <br /> whclherspe,n�ed herein ornoL The�ron(ing o/a pemiit dor.s not presumc(o give au(honty(o PERMITJI <br /> violate or cancel(he ptivisions o/any uther s(afe oi locallaw regula(ing cons0ucfion or Ihe <br /> perlonnance ol consfniclinn. That I arn aufhonzed by(he owner o(Ihis property lo perfonn the E I �O�_ O,)� <br /> worir lor which applicalion is made and 1 complq wdh the S(a(e Confnc(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> il. � <br /> � � � ,,,a.,�� 3�� ►� — <br /> SignaWrr, / Date <br /> G <br /> nrw;rn o�wn�o ir � <br />