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Dec. 3r�. 2U14 10: i0A�1i <br />r,��. 037 � ��. � <br />ELECTRICAL PERMIT ARI�LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S7REE7, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257•8857 — www.everotriva.orp <br />/� � .5�. � o _�'h�-� <br />PROJECT ADORESS <br />.- S'-�, _ _f�. .1. <br />�� C�C��y <br />�1f <br />Tananl <br />. (. �'/ d D <br />ldoil Adnmss <br />1 `� `a 5� U�r,;f <br />1.7a11 ACCfesa <br />� � 1`l <br />h7pil Add o�s <br />,� <br />I�IGf?� � � S! L) J <br />SI' 0 Liconse Numbor (roquire ) <br />{CL iu�'�� `�3L/�-tJ.n�• <br />Proposed Uee of �uilding <br />1ao� <br />Square Foolage (If toeidonGal new constmction, remodol or addition) <br />! <br />NumUer of devlG&5 (Il low voltapo) <br />DesC�iplion o1 Work lo Be Donc: <br />Gily <br />Cny <br />Clly <br />CITY DF EVERETT LOCAL SALES 1'AX CO�E IS J106 <br />�Ca �%•23/ <br />I Z 30 --� � <br />C-i>>i'+ i2 -o�� <br />!n e � �/e . ��`"� l � <br />S�moZp <br />:JGf L °- So <br />slotcrz�p �J`�/d <br />�hano <br />%il o � l�oC Z� <br />Phone <br />�'%3��;�-- J3� <br />P�ona <br />�J�d �� <br />Clry ol EVO�BI� Ouslnoss License Nurnber (fOqUired) <br />�P�`'I�E'. � <br />Contracl Pdce of Work <br />�U�N���� (�,31�5�-��3 � <br />Conlool ppr�on/Contac��7-(J��.)y�mail <br />�CfY�'1' `C !'7CV ��TM <br />`J <br />0 <br />FEC ��nD <br />� <br />I hnroby cer(ily fho(1 havo rontl �nd Orarmned this eppllCdflon and know Uie samo (D bo WO and <br />coaiicl. A71 provisions oll�n•s end oidinencos.]ovommp (hi: typo ol �rorN will be camplohrl <br />wheNier specl(od hOroin oi noL Tha �rtmling o1 a pem�it dtws nal piosurna to plvo aufhorify fo pERh7P"4t <br />viol�laorc�ncelfbeprovisronsolanyofhors�aloarlacallewrogu�alingconslmclionorfbo r ��'(/� DiLJ% <br />pedoimgnco ol consWcf�on. That 1 am aufhoilrod by Uin o�vncr aI fhis p�oDaty to podorm lho t � � <br />work !or which appllcal/on is m�Ua and I comply w!(h Iho Stafo Con�actois Law 19.27 RCW and <br />296.200 WAQ � <br />REVIiEoa6�011 <br />