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ELECTt,t�CAL PERMIT AP�i.I�ATION <br /> CITY 4F EVERETT PERMIT SERVIGES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — �.f t��;.�:'_��;�.=,r,t�.:'`"�.�:+=���?_ �;,z�� .,�` <br /> L iet��� � : �i/L�L�`�"`r.��S ct� ��/�-t'�:,Z'�,'� t��c;2� •�jI fJ J 4��r <br /> `.1� <br /> � h� �,i �' , .J i, <br /> PROJECT ADDRESS <br /> ��� ,7a 'r;`i< < i�`'I -7 �.�C1?,�"TT l.v� �(� � L��' � <br /> Owner Mail Address Cit <br /> Y State/Zip Phone <br /> GI w�i�t�'v�r L�,; �;i r>`i�. <br /> Tenant Mail Address Cit <br /> Y State/Zip Phone <br /> �/�ll.l��Lt�,��{:. �LZ'�? « 1(: iib�C `f�t.' I�l In-�iGl-+JviJ�l �%1 ��''�� ,.i /�.r 7 � � <br /> a. `'1 � C' � , :�� �-Z Z - �c� �z. <br /> Elect�iCal ContraCto� Mail Address City State/Zip Phone <br /> �}� <br /> � `� . (%1�7�`l.�, �i- �U� 1,��"� � L�'t; � yT <br /> State License Number(requfred) City of Everett B��siness License Number(required) <br /> �'1�t��..i'��+:i 'v ,�� 2��1,, �"C, <br /> .�.ro i t .�t !'J L� c � <br /> Proposed Use of Building Contract Price of Work <br /> t J �''-1Ni�i L�N t S'C'IMA 9v;t:�+.�.�2� 1�7 v.l LI N�/_�L�'yi� <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltaye) <br /> Description of Work to Be Done: _ ���5����1-1C-/ C��c�,�;�,'y� 5-�iv i N� iJ��='�:-ac-�Z'vi��-�- ��-�:.. l �(.;-�7"� <br /> � <br /> �'�r��T-4i �1;s 5 i ��w'�l v�:l i'i�L�� � v... ��t r2' .', r"r <br /> FEE <br /> CITY OF EVERETT L.00AL SALES TAX CODE IS 3105 � ��r � <br /> ✓ <br /> !hereby certify that l have read and examined this applrcation and know the same to be frue and <br /> correct. A!I provisions of/aws and ordrnances governing this type of work wil/be complefed — <br /> whether specified herein or not. The granting of a permrt does not presume to give authority to PERMI-i�# <br /> violate or cancel the provisions of any other state or local law�egulating construction or the <br /> performance of constructron. That/am authorized by the owner of fhis property to perform the E 1 �r�i� -� f� O <br /> �vork for which application is made and l comply with the Sfate Confractors Law 18.27 RCW and V (J V I <br /> 296.200 WAC. <br /> z ` <br /> J � } <br /> f <br /> �`'��L tCl:�.�i�-'-� � �f '�.=" �,�� '�;;=" <br /> Signature Date <br /> 'i <br /> REVISEO 08/O6/20f4 ����L -�j� ��;/�!� <br /> I L ( <br />