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� ELECTRIC�� PERMIT APPLICATIO►N I <br /> i CITY OF EVERETT PERMIT SERVICES i <br /> � 3200 CE�AR STREET, EVERE7T, WA 98201 � <br /> i <br /> 425•257-8810 - FAX 425-257-8857 - www.everettwa org I <br /> I (y l,sh U'-0�1 � <br /> � ��po �tl � slrze+ ��,-eu�rF,w�h 9�s-Za3 y`� ►� ��5 i <br /> I PROJECT ADDRESS I <br /> I 42.i- <br /> .'S,L.L , i �soc til '� r r�.zi� Wh 9�zo3 zsc- c�3� <br /> IOwnz; h!ail AC4ress Cdy Sla!e2p Phone <br /> I <br /> V Li— <br /> I . � sl ' '/y. ,1 I� f) 2iL-C�3'j <br /> IJr�r� �1.�.� � S"li0 �� ' �� l _ �—�f `( J�'IL'l LUI7 l��� <br /> Tenani 1.1ad Adaress CRy State2ip Phone <br /> 4Z5 <br /> � ; � ��n�; ��n°�+x� �i/�tE�'�f Z�z��s !oF`� l�de W (Ynmwu� c�;;� 9�-v�6 ��y-ib3-a <br /> EIeCL•;cal Con aclor L'r;Pdarrss C�ti Siate2ip Phone <br /> I <br /> ; �',�:I�� �sct'c,bt'�= 253 � � <br /> iSta�e License Number(required) Gty of Everett Business L�cense Number(required) <br /> I11�5����.c/'c.'oi� ' Nt�M�n,S�v.y ��x � � , ��1.� , �� <br /> Proposrd Use ol Bwid�ny Conlraci Prr,e of Wurk <br /> I' � Sbi: 1ho�%ws �le��r� NZS-1'!y—IL� � <br /> ISquare Footage pl residenlial new conslrucUon, remodel or adddion) Conlact Person�Conlact NumbedEmail <br /> i�cn^.�� bcSi�.tc .I,JS <br /> � Z <br /> Number of devices (If Irnv voltage) <br /> Descnption of Work lo Be Done l-L��u � L�� �uc n 1��+1�� ( c'�V'1� �b� � i n LC'f��••� �✓'P�rS <br /> r�� �I..e 4 �`' �I�a,,. <br /> FEE <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �� O� <br /> I he�eby certily fhal I ha�-c read and ea�anuned Ihis appbca6on and Fnow Ihe same (o be frue and ___ <br /> correcf. All prov�sia,s o/laws and ordmances goveming Ihrs lype o!work will be complefed ---- <br /> whefhB�5peU6Bd heiCin or nrf Tne granfrng ol a pernu(does nof presume fo grve aufhonty fo PERhi1T� <br /> �rolafe or cancel fhe provisions olany other sfafe or local law regulating construcfion or fhe /�/y <br /> peAormance ol construcfi n. That I am authorrzed by the owner ol Ihis properiy(o per/o�m Ihe E I=� 1 u f 1 v1� <br /> work lor which applicalior is made and 1 compfy wdh flie Stam Contracfors Law 18.:7 RCIV nnd __ �1=� � <br /> 296.200 WAC. <br /> � ���_,,,(,� L��5� ` ��� ---- <br /> �S.�n Wre Dale <br /> i <br /> IFci�C__::hl'r�.i:`IJ `� . _ . <br />