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ar7do15 A I9 PM F.om laonl Fe.Numeo. ]SJ-d)5-BBBG Pepo 2 a1: <br /> � • _ __.. <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-88'10 - FAX 425-257-8857 —wvwv.everettv✓a.org <br /> � � � � �� ����� � ��� <br /> PROJECT ADORE55 <br /> Owner Mall Adtlrees Cily Swle2ip <br /> O` i l 1 Us�vfv l 51 c� (<'�r�aduzc.r�- �.t�2v�-l--4' �,e`�� � <br /> 7e�a�T Mail Address C�ly Stetei2�p <br /> .�-�� �-✓r�s Nwu� s�� � �a Nyvr� C�13 F-� c��- �� �a <br /> EleGrical Coniractor Mall AAtlress Cily StateiZip �� <br /> � no� �-� �oa _ c� 5 a �o.� <br /> Stale icen5e Numbef (reqwmd) Cily of Everell Business License Numbc <br /> `�IOoD <br /> Proposed Use of Building Conlract Price of Work <br /> �Q,c.� �al�� a53- �� <br /> Square Foot�fle (If residenllal neW conslructlon, remodel or addilion) ConIU PersoNContact Number/[mall <br /> C/' <br /> Number of devices (If low voltage) <br /> Descriplion ol Work to Be Done: �1—�S�t� � v ` � Y�'�J�� � �0." ""' <br /> FE\E, <br /> GITY OF EVEHETT LOCAI SALES TAX CODE IS 7�05 `j��2. �� <br /> I hcreby cerfl/y fhat I have rt;od and examined th�s aAP�«pbon and know thc sorne to be lrue and <br /> correct. All provisions ollaws and ordmances govorning this type o1 work wifl be complefed - <br /> whether specified hnroin or noL 77io gr�nUng o1 a pemtit tloes nof presume fo glve aufhorlty to PERMIT# <br /> vio�otc or cuncr.l thc p�ovislons o!any othc�sfate or locel law rc9u/eUng conslruction or tho � �,�y�' lr D� r <br /> perlormance o1 consWction. Thuf I em ouV�onzetl Gy fhe owner ol this property ro pedon� fhe �U"` � <br /> �vork/ar�vhich opplicolion is madc mid l co ly tafe Con c taw;8.27 RIl1�v enC <br /> 296.200 WAC. � ��.� � \ <br /> � ) <br /> s�gnawre ate <br /> nR�6cD a6oaao�+ ' <br />