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i � <br /> E�ECTRICAL PERIIIIIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVIGES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 426-257-8857—www.everettwa.org <br /> i <br /> /--O�'� 5� <br /> I �� I � S r . .� 9�LD 1 % l,�C�' --l)�3-(''/ <br /> PROJEC7 DRES3 <br /> � -��e 1/�-�Z' Z�3S <br /> �mer A1ail Addros, Gty SlatelZip Phone <br /> Tonant Maii Aadress Gty S�at�JLp Phor,e <br /> Wzsfe.N ; 253 -8y�- <br /> < <��- ,o�P���., E s�.� Pti��,��,.,� .�✓� 4�3�y Uyo9 <br /> EleclriC81 C � BGlot Matl Address Giry ��� Sh��e/Zip Phonu <br /> �I � <br /> OZ u i i.O��'l �T��IZ� _�i0;��_ ( ) <br /> Stale Licen .Nun�ber(required) Ciry o Everett usmess cense Number required <br /> I Ce.4 r ' ��e. � IO '-v00 <br /> � ProDosed U o1 Ruildin Conlrecl Pnco of Wodc ' <br /> ; � � � b���S7kr4- �n�� <br /> I COM <br /> w e co � w�e_ ��t' t�1��d 6��Is y'�3 `6`�S�o`loq <br /> � Squaru Foo �� e If rasidantla ew conSWctlon,remodol or addlUon) Contncf�usor/Co Inct NumbadEmyl <br /> I I <br /> Nui�f � 'res(If Iow voltage) SGr�'� <br /> �� <br /> Descriphon_ . Work 10 8e Done: �n _ZUl7 ��2 /1 fa ('J�/b��h�_tt{�1`►' hFh�—__ <br /> � � <br /> I F�E <br /> CtTY OF - RETT LOCAL SALES TN(CODE IS 3105 �7 C� .5� <br /> � (i7 <br /> I horeby Ce`� that I have read and examined this app!lcab�on and know the seme to bo Wo nnd _ <br /> correcf AIF iuvisrons ollows and ordinancos goveming this rype olwork wi1/6e completed - <br /> whethorsp fiodhoreinornoL Thograntin�7o/aABrm�tdwsnotpmsumofogivcnutAairyro PERMiTt� <br /> violal0 0�c �ccl fho proViJons of any ofher Sf�fn or locnl few lCgulatinp consMlC11011 O!fho � � �O � — � �� <br /> poAom�an � lof consWcGon. Thef 1 am aulhonzod by fhe owner of this proporty fo porlortn fhe <br /> work!or w �appllct�Uon fs madd und I cumply wrth tho Sfoto ConVactors Law f 8.27 RCW and <br /> 296.200 W . <br /> i <br /> zo /5 <br /> �� � � <br /> I � <br /> ftLt'f:.GD 06 �.. / <br />