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OB/13/20!C 14 77 FAX 2067630506 �002/Ob3 <br /> �� • � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER4ICES <br /> ' 3200 CEDf•R STREET, EVER�T7, WA 98201 <br /> 425-257-8910 - FAX 4Z5-257-8957 —www.everettwe.org �`�C� _�� <br /> . Cil�o� �Q� <br /> �ZO S ,,��s wt R*! I�cs � ��dZ <br /> PROJECT ADDRE3S <br /> to�- ������J � �ox 53 g �✓�ev�c� �i��'�b ���ir� - 76� <br /> Owner—r M�IIAdtlron C4y Slol��Z+O Phone <br /> �S �l.clJ \I�nLFSM�+yi '1n1�{'��Z/�I�C✓G lJl��9 7� � J/2-'A'1'L` <br /> Tenent ollAdd�aes C'}y S,a� � P�one <br /> VF�l4- �7,� � �x �U`f6� ��-rrc� � 98ir/8" z� Y3c sx� <br /> ElectNcal Conlredor ht�IlAadrow crty S ts2lp P�^s <br /> ���U4� C� S�2 I�i�1�1 OD K`�'�� <br /> Stete Uoense NumOor aquire� G�ty of Evnroli Buainess License Numbor(raquired) <br /> ���'/ O �99 , � <br /> � ��� <br /> Propoeod Use of Dulldmg Conirscl Ptice of Wotk <br /> � �t'S S.� .c= �p�c.r.F-��cSc�o✓1 1�� bq,� ?.�55 <br /> Squere Footope pt re ' ential new wnsWction, remadet or addi6on) Contad Pe�sonlContad NumberlEmail <br /> r32,-cr..� . �',�cl�-�,.�C,�,�c� • �ow� <br /> Number of drvices(If low voltage) <br /> pesc�tptlon of Work to Be Done: �re�IIL�N� �`�N1'JP F6.�`�-� � �/�'��►ti'7 �t°�Z— ' � <br /> nu-� (e� condu.c-t��r f''x-(�.�r�'s, <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 � I �] S� <br /> ( <br /> I horrby oerMlY thef!have raed ertd examined this applicah'on and know fhc somo to be frue and <br /> �o�ct. All pmvisfona ollews and adlnentes qoroming thls rype o/work wlll De completed <br /> whethar 9peci�ied herein ar nuf. The B�rtUng of a Permit does not prvsume to gtve euthortty fo P�RMIT# <br /> violate or cence/tho piovlsfons of any oMerateh�orlocellew�oBuleUng consfrtrcBon orthg ^ � �O� ` ��� <br /> peAormence o(conshucA'on. Thet I am euthonzed by the owno�of fhls prvporty fo perlonn fho C <br /> work/or whlch opP1�cutlon la meds and/complyWith the Sleto ConfrsCtors Lew 18.27 ACW end <br /> 2pe.200 WAC. <br /> —��K��c " gl���,y <br /> Doto <br />