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^�?:ti'e:SGV 'r�'eC':RiC I�C R25cc ?.:�0'_ /CC'a <br /> :3!Si':, '_� 0'.:fi ?6;G";C�:25 - <br /> i <br /> I_ � �- I' <br /> � ELEC'TRICAL PERMIT APPLICATI�iV j <br /> , <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREfT. WA 98201 �{'-I "1 3 i <br /> 425-257-5&10 - FAX 425•257-885i-wJ�nv.everetriva.org ��30�,��b <br /> APPUCATIONS ARE ACCEPTEC FROM 8 AM TO 4 "M � <br /> � <br /> i II, � z.�OZ �Uc�e� ��� <br /> i PROJECT ADDRESS � <br /> i <br /> I� ����c�.J�.-�' `1 Z i l� -7'�, ivuJ �.)�<�t/t �,,n 9�ii7 2cb• �rri-�v <br /> � Ovmer Man nCCress City Sta!e�Lp Phor.e . <br /> i <br /> I � <br /> i ��r. _r.�.�, ci.S A�Bo tC - � <br /> Tenant Mail AGCress Ci,ry Stat¢/Yip r'noi�e <br /> � �onn�1 s�n Elcc.-t�� i�� n,um, olv o� a-�I t�c�-� ' wA�/991z3 �'�O)435-5n� � <br /> � <br /> ; EfeU�KdICoNraclor A1ailACeress � Ci;y btat 1Zip Phone � <br /> I <br /> CQ I <br /> � Do�neeyo�iu �z �a��. � <br /> : State License Number Comract Price of Work <br /> i <br /> S't'D�cie�� J��w',rCS. �1� ��— �'� <br /> I Proposed Use Of� uiiding Centact Person (Plan Reviewl I <br /> � <br /> i Descr.pti�n oi Work to Be Done: �/�Jh�^� /�o'fx 7 �% (J/J ��2S ���a� �`����', i <br /> I _ I <br /> i i <br /> � I <br /> NOTE: VVIRiNG IN NON•DWELLING515 REQUIRED TO �E � <br /> � . BE IN RACEWAI'S. MC OR AC CA6LE.� I �, �� <br /> . I ' t7��L7 �) � ;. <br /> � CITY OF EV[RETT LOCAL SALES TP.X CODE IS 3105 . <br /> i <br /> �� I hereby ce4i�th3t 1 have resd and szirrrmed lhiS 3pplrcatiun and know fhe sams:0 6e Su8 3nd i <br /> � rorrCCL All provis�ons o/laws a�.N oldmances govemir,q this type o1 wor6�will be CumplEfed '� -� � 1 ! <br /> robefher speci7ied hsrGin o�noL The grantino o;a psrm�'does nof pre5ume tc giv�nuLionty to t.- I .-��� '(� r �' i <br /> , violateorcancslthe provisicnsefanynthers121POI�005113wregulatinyconslructior,Nfhe <br /> perfomianco c�a+nstrtrction. That I a:�r 3uthonzed by fh,e or.ner of this properry t0 peAOmi Lhe <br /> �rcrX!or�rh�eh aFP���a;ion!S m3de L.�.C'I compty lr(th 1he Sb;fe C;on(ractol5 L3w 19.27.4CW and i <br /> I 29&200;h'.1G. � <br /> � � ��� _ yj/,� i <br /> ,�« o.,F <br /> � � <br /> i '. <br /> � <br />