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ot/ta/zo15 weo 15:a? Pnx <br />ELECTRICAL PERMIT APPLICATION <br />�ooiiooi <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 42F-257-8857 — www.everetiwa.orc� <br />/��/-/� � <br />�=�So�-�� <br />15 BW EvdBIIMILI Wky EvnreR NiA0874t <br />PROJECT AODRESS <br />Mua 9ev 5ams e� orale^-t ecerau <br />OWncr MallAddrwse City SWtdIJp P��«�A <br />67a11 Address <br />ciry <br />Stat9fLp <br />PMnx <br />LSDOBk�ndMarulacv� R757CCmirn�cov�6�D�wl000YH'AB9510 BGJ.4FA.28tS7 � <br />EltldtiCal COnUeGlO� Mall Addreas Clty Staln2lp Phnne <br />ISOE9�M07a0P <br />State Licanse tJumber (requlred) <br />MUC BBy <br />Praposad Use af Buildinp <br />L(lal. <br />Square Pootape Qf residenUal now construdion, romodel or eddi6on) <br />z <br />Number of devices (If Ivw vollape) <br />o20D00 <br />City of Everetl Business License Number (rcqulred) <br />50.800 <br />ConireG Price of Work <br />JLm�FYm�0oa5a2BB7o �lyln bnam <br />ConleU PersonlContact NumberlFmell <br />OescriptlonofWorktoOeDone: ��i�iroznn�c�ma��imnore»�mie.,�dwa�i.eon�nurn. <br />CITI' OF EVERETT LOCAL SALES TN( CODE IS J108 <br />1 he�eby ceitily fhal I have mad and oxumined this epplicahon ond know (ho samo to bo (rvo nnd <br />conect Nl provisions o//ews enU ordlnencnA govorning fhla fype o! vmrk w/fl be complofod <br />whefher spocifiod haraln or nof. The grnnflrtp o! e pertnlf doos rwt proaumo (o glvo authority fo <br />violuto or cencal !ho p�ovlalons ol any other sfafo arlocel !aw ropulnting consttucY/on or fhe <br />poAo�nanoo ol canstruc!lon. 7haf 1 nm eutha�lzed by the owne� o/thla prope�rty �o poAorm fho <br />work /or whlch nppllcallon fs madn nnd 1 comply wlfh fho S�ofo Controetom Law 1 B.27 RCW and <br />qEVISED OP,00/MlI <br />FEE <br />�.� d 0 <br />PERMIT# <br />E ��D(-OBO <br />