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! <br /> i�� -- -- -� -- ---- — _. ... <br /> - --.--- — --- --- - • ------ -- —�i <br /> � <br /> � ELECTRICAL PERMIT APPLICATION I <br /> , <br /> � CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> j 425-257-8810 - FAX 425-257-8857 - www everettwa org <br /> I <br /> i <br /> � a�� � Pari��c_ Av� — , <br /> PROJECT ADDRESS <br /> ���. a�����.n��,c G,i-[�� SanJ 12AFAEC 3 �A 9�11v3 <br /> O�•mer 'c1a1�daress Cdy State2�p Phone <br /> ��a,��rn1�,.liiii�ts��F7wMf3/r4-�/Nt 71/�ij�A IFI UE. �(E/1�T-i� yO�l y2L7�.�Z� <br /> Tenanl tladAadress Cty Sta;e%Z�p Pnone • <br /> QLYmt�1��6Cf�—�'�c ���2 iB (�rt+ A�_iJ;-�wr�4.2�0'�.�,rLv.r��£�. .�.�,a 9F1'x�� � <br /> �� [lecincal Conlractor 61a�1 AtlCress Gty State/Lp Phone <br /> ' I <br /> CC OLYP-fNI�I002DC'� <br /> � Slale License ��umber Contracl Pnce of Wo�k i <br /> i <br /> Proposed Use of Bwlding Contact Person (Plan Rewew) i <br /> ISquare �oo!age Q!residential new conslruchon, remodel or add�tion) I <br /> � • I <br /> , _ _ .. . . _ _ _ ._ . . � -----� ��-- - -. � <br /> - — _ ... _ <br /> Number of devlces QI Iow vollage) <br /> �j Descnphon ol Work lo Bc Donc ��rc 1 i����—�+-����� J i `'�---__._ �� <br /> � ���- -INSt�_�!�,�� T-Sr�-r I, <br /> � <br /> -------- ---- - --- - - <br /> Fer_ ' <br /> �� � <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I <br /> ��II hereby cerh/y thaf I have read and examined thrs app6cation and kno�v the same fo be 6ue and — . 'I <br /> coriecf All piovisions ollaws and ord�wnces goveming Ihis fype ol�vorh veill6e complefeA <br /> ivhr.fher specifred f�erein or nof. The granh��g ol a pem�d does nof presume!o g�ve au(honty�o PERMTT# <br /> I v�o�ate or cancel thc provisions o!any o(her state or local faw mgulaLng constn�cfron or fhe <br /> perfomiance o/consf�uchon. That 1 am aufhonzed by the o�vner o!Ihis properiy to peAomi fhe E �30�' — 3 � I <br /> �:�ork�or which apphcalron is made and I comply w�fh the Stafe Confractors Law 7877 RC W and <br /> � 296 200 WAC , <br /> ��,�.�,1 lo-�7- 13 <br /> S�onatore Dale <br /> i <br /> nc�nscr,_,. �, - -- � <br /> \ <br />