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� �� -- -�— -- <br /> ELECTRICAL PERM!i APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320�) CEDAR STREET, EVERETT, WA 98201 G — S—/lJ <br /> 425-257-�3610 - FAX 425-257-8857 —wv✓w everetlwa.org � � (,�D6—O�(� <br /> � 8 � � S,u,TK �4�,- � <br /> PROJECT ADDRESS <br /> I �NIL �.STEP P(� /'J�r li`1 c'�t4�-� 1.�i4 `t810L 415-�5,7-4�t.�8 <br /> Owner Mad Address Gty Slale2ip Phone <br /> <<�� S�a,�� Nn�' Fv����.,� t.rA g�c.�oi h1iaQ- ySdF <br /> Tenant P+ta�lAdaress Cuy Siate2p Phone <br /> L LF r41�. �y0`1 �''fc��rue.�u- A��c El��s'Ir�v�1 94Uo1 4�i-,�s.1-r)U� <br /> Eleclncal ContraCtor tda�i Address CCy StateiZ�o Pnone <br /> /� 4 .v <br /> :/� NIC�I `�]4 (�2fJ UU� ^ _ <br /> State L�cense Number Conuact Price of Work <br /> Pwposed Use of Dudd�ng Contact Person (Plan Feview) <br /> Square Foota9e Q(residential new construclion, rcmodel or adddion) <br /> Number ol devices(II low voltaye) <br /> DescriplionofVlorklo �eDane� � 1�i,� ��L�V C���:.�U„1j_-__fn[u� _S�Gk:�.�iTy <br /> -- Cf�V�I��,'_v15 -- -- -- <br /> F[[ � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 �/_ ��7i �� <br /> (P V <br /> I he�eby ceddy fhat 1 hnve read and rxanvned this applrcahon and krro�v fhe same fo be Irue and _ <br /> conecf. /lll provr5ians e/I�trs and ordinances goremmg(his type o/t:orN a'ill be Contplefed — �-- <br /> whe�her spewhed herein or no1. The 9ranting o/a pemrit does not p�esume(o give aufhonty fo P[R61fTk <br /> wolafe or canr,el fhe provisions o/any o(her slafe or local law mgula6ng consln�c6on orlhe r <br /> pedortnance ol cons(nic6on Thaf I am authonzed by the oivner o/�his proper7y(o pafomi fhe t � �Q� , O (.�-71 <br /> �rork!or ivhich appOcafron is made and I compty nvlh the Sfafe Conlrac(ors Law 18.27 RCW and I U <br /> 296 200 I <br /> ti � G- s- � � <br /> Signature Date <br /> eevisEo v�a�u I <br />