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NOV-19-20�4 09:59P FP.Ot9:PROFE55IUNRL ELECTRI 360 435 1182 70�4252578857 P. 1'2 <br /> • � <br /> . _ . .— . _. . . . _ . ._ I <br /> ' ELECTRICAL. PERMIT APPL.ICATIO�B <br /> CITY OF EVERETT PERMIT SERVICES <br /> i 3200 CEDAR STREET, EVERETT. �fJA 98201 <br /> 425•?.57-8810 - FAX 425•257•8857 -v�vrw everethva org � <br /> � 12 �-oi--��f I <br /> � s��� ,�s�� c-�y,z.� Z � <br /> �,'�p�� .C'.- h,, r .t' Q' o--. L!/•._ <br /> PROJECTADDRESS <br /> I ' --- -- <br /> ����n.�u 1,��?�X,__S�7 ✓c .f'S�c.. G✓�. tSr.-ekff" ��,/.A �7�0� � <br /> ��vnci I.ta�lACdress � Cdy � 5!ate�Z�p i'i�o�e <br /> _f-vn.��. _ <br /> I enant '.tad Addross Ciry Slate/Lp Phcnc <br /> �n / ��f' )_�v .) J� i <br /> I � / `r'_1 i i c-.-.. / G�r a. /L'� L .1.� G / G� /J ��/`7 ��'�.n � R�-. G/�/ `/ .�a� 7 <br /> I <br /> Eiectr�calContracter Lta��iAddre,s C�ry Siaicil�u Pnona <br /> i I� /' i:� f�v/i 1-O 7 7 k-.�l �_�� '� � - <br /> i �iaie L�cense IJumbcr(required) City ol Gverelt E3uvness License NwnCei i.�equ�reJ) � <br /> i i <br /> ' �r. lf��o✓JL _—"". � <br /> __9��___.. <br /> F'i�,yuseJ use cl BuGUu,y CONrael Price el Worl< I <br /> � I� <br /> Syua�e Footayo pf resident�al new wnstruclion, remotlel or adad�on) Conlan Peise:�./ConWd NumbeNEma�l I <br /> rJumucr ol Uevices (ii low voltage) I <br /> Dc;cnpllon ol WorY, to �e Don� ��� �_�_d�� 1��� ��_�J __ <br /> I �r� ,L(c iP A 7 .r n —�_ . --- ----------— � <br /> I <br /> I <br /> i Fr[ � <br /> I CITY OP GVERETT LOCAL SALES TAX CODE IS J105 / �"^ � <br /> (Ql(/ � <br /> Ii he-ehy�certdy fhnl!hnve ieud and examinod l/ris applicolion andknow(he sanrn lo be huo and __ __ _ _ <br /> c�rmu Ail p�owsrons ollaws onAordinancos govornrng Ih�s type o/wodr�vdl be conrpleled - i <br /> I .vnMher sperd�ed ho�oin or nol Tha gr,nl�ng o/a pemr�t does not picsume!o g�vc auihonty�o PERhtil;'. <br /> u;o�nte or cancel flte provrsrons o/any olhor s(afo or/ecalla�v rogulohng constivchon or 1Ro I _ /FtD^ � <br /> Iperlormonco o�consuuc�.on 77iaf l am gulhonzed b}�Ihe o�vnero!�his pioperty to porlwm rhe E I� �� v � <br /> wnrA lor�vlur.h npplica7ion�s mada nnd I comply wilh fhe S(afo Conlr�Gors Law 78 27 RCYV ond L� <br /> I �9G200INAC. I <br /> _��S-CG? /�'-_'�>yc � <br /> Slanoture � ��Va��� � — � <br /> crt�S'Opp9G.:Jf♦ __ . — _ _�"'_ _"._ .I <br />