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� <br />1 <br />�, �; � f7J � II <br />� ��� 7� � ���Ltl <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STR[ET, EVERFTI , V'JA 98201 <br />425-257-8810 - FAX 425•257-8857 - www everetriva org <br />� �=1_� '�2'm-1 \'�-- �� <br />PROJECTADDRESS � <br />�--0�.1�-r,�, i_J �='�'-1� <br />-- - --- — --- - - - <br />OwnCr 1.1ai1 �tldress Cr.y <br />I enani <br />tdali ACdies.. <br />Electneal Contrador lda��� Aadress <br />�11�,�\\'tY��1�� J�1 <br />S!atc I icense Numbei (reqwred) <br />��1 Cr.y <br />�`�`� � �� ��� <br />�(�, ��,�c <br />G', y <br />f'roposed Usc u� Bw J�ou <br />1 ��� `�' � <br />Square footage (II res�denhal new consiruction, remodel or adddion) <br />C� <br />I Number of dewces (II low vollagc) <br />��y�z _03 � <br />/��5-�4 <br />�fJ� �i `��� <br />Sla:c!Zip Phonr <br />State�lip P�one ! <br />� QYC•(� , ���'�_C�1:i7't <br />�� <br />Slate2�.p Phone <br />-�•!__I..LL `—` •-- <br />Gt ol Everett Gus�ness L�cense Numher (reqwred) <br />1 <br />-- �------- —_._...—. . <br />Coniract Pnce ol `No�k ���� � ��� <br />� �-�-� J�� <br />����� i -- - ( ->. <br />Con�. U Gerson ::ontact NumbeiiEmail <br />� Descnphon ol lh'orh to l3e Done _�—V V 1�` `�� �_ H� <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS J105 <br />I hcmby cerhly fhaf I h ive mod and cramrned lhis apphcahon anAknow fhe sarm� (o be liuo ��nd <br />rorrecf All prvvisrons o/ la�vs ond onlinancps rM�emrng Ihi; lype o/ work �vrll be cornpfMed <br />whc�hcr spc;:diud hcr��n or rrol Thc gr,indng o! a pennd does nof pmsumc to grve dufhonty fo <br />wolafe or cmuel the provrsions ol any other sfafe oi local l��v requlahny consfna'hon oi (he <br />per/onnance ol consfruchon fhaf I em aufhonzed by fhe nwner ol this property fo pc�lorrn fhc <br />work lor whrch apphcahon is niade anAl cemply wifh fhe State Conlnc(ors L�w 78 27 RCW anA <br />296 200 N'AC. _ �� <br />'" � % -� - — <br />S:gnalme �-�%f - ----Da'c --- <br />.. �_wis_•.�.,.v <br />F[E <br />��[r� <br />� pERh11T,r <br />� _E I �} I :� - D35 - <br />