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�LECTRtCAL PERMtT APPLtCAT10N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEOAR STREET, EVERETT, WA 98201 <br />a2&257�8t0 - FAXq2�2y7.gg57—,�ww.evetefmva.arg <br />`� �o � �� ��e. s� L c�� 1 <br />PROJECTADOR£SS <br />'` ,, 1 1 j 2-O S�; � � Q:-P�t /I�a.%/ C4 C•'� <br />��`�- �� �iC.�-�nC. SIJL}� 16� �i!� <br />oK„� <br />Tenant <br />� <br />�-., . . , ..,. <br />n�.a� aaaase <br />nsai� Addmss <br />Mal 1+�� <br />� <br />C�y <br />��� l�ll� <br />n �Y <br />fi �1'iE���3�,�-� <br />Strte �cense Number <br />t`J t +n,� � �,c.� �XX i ✓�._ <br />Proposed Use of BuilCing <br />`3.Sv c <br />� � c►r� �.,��. �a x�„� <br />Number ot devices (It low wltage) <br />I,v t�- Q�'1c� y <br />�D <br />StatrlLp <br />G�i� S�r �L <br />Sl�o <br />Contrart Rioe d Wa.1c <br />ud i <br />9 � 3 ���8 <br />Plqne <br />PAane <br />f' 3�7 S�v� <br />PMne <br />Confad Person (Plan Review) <br />1 1 -f <br />Description M Wak to 8e OonP� ��� ��� n+' -�MJ �/,Y� jr� �`_- �(Y �� i..� e'� �/ � <br />� '� �- "I�.: -I� 1' �o :.�— � <br />C�TY OF EVERETT LOCAL SALES TAX CODE IS 3�05 <br />/ he�ehy cer+✓Fjlh�t t h, va read and examned thls applicaBm yx1 /r�q� � y�� ry� Ge tr.ie and <br />corretL M provi.vons oflaws and rnrSikvice.t gowertwy /his rype of we�rk wdf be wmpleh,d <br />wAetherspedfiedherra�ornot TTegr�tingdepemrRdoesnalpresumerogiveaunorflyfn <br />violate or cance! the pmvisons of any olher stste orloce!!aw mguFafing constnic0on or fAe <br />performance o/cvnsfruct/on. 71r;�t / am au(honzed by fhe owner oflhis pmpeity fo pedorm fhe <br />work /or which applicafion ls made and I cnmp/y wHb 7he Slafe Can6actors Law 18,2i RCWand <br />V V <br />F�E � <br />�0 / <br />PERMCT� <br />E 140C�-02 <br />Z�d d£Z�Z04L £0 �^f <br />