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ELECTRICAL PERMIT APPLICATION <br />52 � 3 No.r b��k <br />PROJECT ADDRESS <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425257-8657 — www.everettwa.org <br />G�re�c, 1,�A qgZu3 <br />t� -a � -�� <br />� �u��-a�S <br />C.G� %�cu�rKnrl %�F��.. <br />Owner �' MaBAAEras CiIY S�fiZD Phm <br />Tonant <br />Mail AdOmss <br />�Y <br />Fo2.caSk S��Io� LLC 2�70� ��^ANe..,�t s+e. L, r�vfhe6l � WA N8o2-1 <br />ElectrinlCorNacmr Ma�Address Cily Spfi/Lp Phore <br />ro�L�2s � 30L� <br />State License Numbcr (required) <br />Proposed Uso of Building <br />Square Faotage (It residenUal new cons4uction, rnmodel or addrtion) <br />Number of drvices (It lowwltage) <br />o4�r�67 <br />Cily ot EvereC Business Licen� Number (requirad) <br />�i0.2cKJ <br />Contract Price of Work <br />CorKad PersoNCoMact NumberlEmail <br />Dasmptio�o(WarktoBeDono: RotrG Y�+o�ln-iC�t %.% k�.J 1��i ,�i�Gf �Y�2 S�{S�e✓N. ZS-IitIL275��/ <br />� <br />5��� n,a�(�ItG� an�Q lY AP5 m�r_ro;�v�.rkers, <br />CITY OF EVERETT LOCAL SALES TAl( CODE IS 1105 <br />1 heroby certily fhet I heve raed end ereminad fhis eppfrceh'on end Imow tho same fo bo fruo end <br />correcf. AII pmhsions ollews end ordinencos govoming fhrs typa o( wnAc wdl be mmplatod <br />wiielher specrficd hemin or nof. Tha granfing of e pomdf doas no( presume to give ouMo�rty fo <br />violefo or eencel tha provisions o/eny ofhor �etc otlocellew iogufeting wnshveh'on or fho <br />por/ormenco o! cnn�rud�on. Thet I em eutlrortzed by fhc ownor o! fhis prvperty fo peAorm the <br />work lor which epplicefion is mede end I compty wrM the Sfefe Canhadors Lew 18.27 RCW end <br />296200 WAC. <br />� �' <br />atvisooaae2n� <br />FEE <br />50 -od <br />PQtMIT# <br />E ( �f ll� ��J <br />