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� <br />ELECTRICAL PERMIT APPL,ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 42S25T-8857—vyyyyy.evetp��.�g <br />�1 �: �l �t -�i� � L S E <br />PftOJECT ADORESS <br />� r, I,}v S:u C.� f>'hlI ��c-� <br />SeG.F1-lc. Q�.ri� 5�.1., lv�� ��ev�I�^ <br />a,nwr <br />Tenant <br />r-err1N EIQcHr��'�.� <br />��;m� c� — <br />nma acd,�a <br />Mail AOdmss <br />Mx� /1dRr� <br />�Qs��E,43�t�� <br />State Lioense Numbcr '— <br />Prcppsetl Use aT Dultlmg <br />�N� F�'+�* (tl rt�aderrtcM ��v m�strut60n. iCmotld W�i[ion) <br />NumOcr of devicos p( low vollage) <br />Drsoiption M wonc to Bo Donr �� �� 1' �� <br />c+� <br />Gry <br />� <br />r�- 93;3n y <br />�+dr,� <br />SlatnlZP <br />SfE�p <br />Corrtrad Pri� af Wark <br />.�Ji; 9 i 3•�-PGJ <br />r�l,w,c <br />rmrre <br />-f 3375'3i�s I <br />i'hmn <br />Contacf Person (Plan Reviow) <br />FEE — <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS J105 r^ /j OD <br />I hornAy ee�tCy U�at I hnve �cad anrt nzamfnvd Cus appOwfion e!#Wrori Uro senre fa 6p fraa end <br />v � (J � <br />ooned M provisans of fews anda+tlnanor.s pov[vrting tlds fYlx a�rtkk w�l De axrtplBfad <br />wfiM}rcrs7xr.tificd Aerein orrtot �i�e yr�nOhg ot a pc�mrf tloes naf pre.sim�e ►o prve ntrtho�y fa p�(H�p <br />vmlahr orcanccl the provlsions d eny olfrer stale or local law mgulating canshuct;nn o� t/re E ��b� 0 7� <br />poAonnoncc d consfnicLon. TAa! I am aufhorhed by Me owner ol thu property fo pedorm fhc <br />work lor w•hfch�ppUcetlon �s made and I compty wiU� fho SYafe Conha:lors Law 18.27 RCW nnd <br />,.,� �� �..,,.. <br />-.�-r�; -.� <br />y � 9e![L�E9ZV <br />ou�oul�o�3wue� �£16041 lll�f <br />