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ELECTRICAL PERIVIIT APPLICATIOf� <br />CITY OF EVERETT PERMIT SERVICES <br />3'L00 CEDAR S7RFET, EVERET7, WA 9a7_01 <br />4?_5-257$t310 - F(�( 42�-?5l-8857 - www,evereL'�n-a org <br />1 a �� f g�-� r�. �� <br />PROJECTADDRESS <br />� �So��� l� <br />S �-z8�� <br />� <br />I <br />���;���q�ss ��.a.- U�S. 33�, q3cr� <br />(du.t PdrLn% C�; � <br />Y $I:i'c;l.ip Yho'tq � <br />Tenant 1.'.a!1 Atl9re65 --- �-- I <br />—^�rY Sta;c/Lp Phcne <br />I <br />�LVLYIA-n_ A-�1 Yw � �r OL g 1'��,�•�. �-i -� _l_lJ0. q�I �o$ .� �b�`i��� D b <br />Eler.(rical Conlraclo• t.te�� nd�ress I <br />G�i Sta:a':.ry Fhcno <br />S;ate ic_�rapuirptll - <br />I�'�ouosea USe of Budd�np ' <br />I <br />ISquare Foo�24Je (If resldon�:�l new consUuclion, remotlel or ��di;ion) <br />tJumber of devicas pf low voltaGnl <br />O a 30 <br />City of Everet, Bueiness Liconse Num6er (requvod) <br />�' 3 bc� <br />Coitract Pnce of Wark � <br />�m,� ��� a� �����bo <br />Contact POrsnnlCon��ct Number/ mail <br />� a� m� c� br �, r�c.,, �.y .�,ti-� <br />! DeaeripLon of Work to 8e Oane' ��,�1 l G r� C v l•t- �w/ <br />I <br />CITY OF EVERFT7 LOCAL SALES TAX CpDE IS 3105 <br />! fiem.0y cerLty thnf / havc iea� a�� exdmined Uris applka;ioq entl Fnow Ure same to be We nnc <br />conpCt A/I provisions o//aws and Orriinances gove�niny 7his flpa of woik w�ll bo cOrnple7a:1 <br />whother spec(fied herern or not The ynntmg Of o permlt does not p�esumc• to giva outhon(y fo <br />��0%J(e or �(�nCo! rl)e p/ovigions o! [�ny othersfalH o� Iof:J114W �o9ulytrn:f consVUCt(ori pr fhn <br />pei/ormr�ntn ol consbuction. Thaf 1 um authenz�d by thn Owne� ol this property to por7omr Iho <br />uvrk lor wlrrch applrcation rs made and I comply wiU� �hr, State Confreir.to�s Law 18.27 RCW and <br />2�£ 200 11�AC. _ <br />RfVrJE054 �i:ur< <br />/ /� <br />FEE <br />� �5D,�° <br />P[RMIT# <br />E15�- ��Q� <br />