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- �. -_ . -- -� -- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES u <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C� l�I "a0a <br /> 425-257-8810 - FAX 425-25i-8857 -www everettwa org -� ...�.�— � lf <br /> Rurin�;J�vcrrlt I�ai ih1�;f,Ruildin�+ 411�HI.H?.Hfi) 3un� Wrc� C:�sino Ruad, I�.vcretl. WA <br /> Y820) PROJECT ADDRESS <br /> Ilueing [:vcreU I�acilit�' J003 �Vcst Casino Road _.._ Evcretl_ �YA 9ti2P3 (206)949-0714 <br /> Ownei Ma�i Adaress C�ty StatciZ�p Pnone <br /> S8I11C JS nH'tll'f ___._., _._— — <br /> TC�7M A1adAAtlre55 C�ly Slale2�p Phone <br /> sitc:206-6R3�3469 <br /> VECAEIcitrii ______56�q_7ihAveS Scattic WA9HIOR nfficr.206-436-5200 <br /> Eleclncai Contraclor � nta�i naeress Gry S�a�r.iZ�p t�none <br /> i VIiCAE�.(:I542�IU 51,79R,?6I.00 <br /> Stale License Number Contract Pnce ol Woik <br /> Manu�a:turin� F'atrick"fillrylSaran��206)2t,7 17U0 <br /> Proposed Use ol F3wld�ng Conlact Perso� (Plan Rev�ew) <br /> N/A <br /> Square Fonlage(I1 resideniiai new construs�ion.�emodei or adddion) <br /> n�� <br /> Number af dewces(If low voi�age) <br /> Descnp�ion U�Work lo Be Done (uyL�ll i00 K�1' ��e�cl ecnerals�r an I inslall (7uy�y��1:�.[\S�s;llCillViS. <br /> Pruvulr +��per,viun idcmcrgcnry and s�andhy cicctncal I�a�ds, milu�lcs muvmg hranch cir.urts and IceJcr. <br /> fnmi czisting �t�I1CIIlO,Ifllti IU I1CN' .II1lU11f CtU�lfl}! p.���rlb��ards Uiuti �unviJin� rcqwreJ srper.�lion - - <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> 5 I?.193.N7U <br /> I herrAy r.ertdy fhal l havc reaAnnd c.ammed fhrs apphc.ihnn and Anow Ihr sarne fo he hue anA _ <br /> conetf Nf prov�s�ons ol lairs nnd ortlrnancr,s qovn,mmg lhis lyp�ol wo� �vdl be complefed - - - <br /> whefher specfieA hemur or rro! The q�antinq ol a pennrl Anes nof presmnr to g�ve aufhontyln PERMIT# <br /> mo�ate or cancM fhe provivons ol any olhr.r slafe oi lor,ai!aw reyulaliny consfruchon or Ihe ^ <br /> perfomiance . is�n�chon Thet I anr authorrred by IhP owner ol thrs prnpr�y!n PeAorrn fhe t I �f O � � �7..� <br /> worM�or uch ap hcahon is made and I c nply wdh fhe S(ale Conhactors LaN- 18 27 RCW and _ . � __��� <br /> 296 AG <br /> � - �� ; ��� <br /> SignaWm Dale <br /> aevaeo�x-i� <br />