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OCT-07-2016 10:24 FRO)- <br />T-600 P C01/001 F-966 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetthva.gov <br />a6*3 I JAI awt <br />PROJECT ADDRESS <br />e 1510 -0y z <br />/0_7-15 <br />�AcFf, a/ 3v�J r. CCMM��C:11C CI. M__ r2:a:ws1 <br />—p 3641 <br />1i-asJ-$9 <br />4 <br />Oy,nor <br />Mad Address Cty <br />Slawfz-p <br />Phone <br />I I <br />t <br />Tonant <br />Mwl Acdress Ud) <br />State2ip <br />Phone <br />SM< �O�a�:JJI <br />Lie Sa {T j,�a.+0 4y ea4e >-� <br />tJ.? S�Yi�i <br />7i3 61c, <br />7 <br />/Oldl <br />Elocirical Contractor <br />M311AdCres3 City <br />State2i, <br />Phone <br />S ilc' S-09'L 1�1'31 IC 1 <br />State License Number (required) <br />CIDmrvlerzC;j}(- <br />?r000sed Use of Building <br />Square Footngo (If residenJol new Censtructidn, remodel or addition) <br />Vy,�-fl ) <br />C,ty of Everett Business License Number (required) <br />_ 00 . u --� <br />Cent, act Price ct Work <br />j",yc J:G'% M•KkJC�SrNc-�o i-.f <br />Contact PorsorVContact Number/Email <br />Number of devices (If low voltage) <br />Duscnptlon of Work to Be Done: t1l t> k (,- • ,•-> �� �•� s 1 F <br />C" i•r C ri-� bm4,t• ".% c 4,o rli< C o .l ki u If e- <br />FEE i <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 51J 06 <br />I hereby certify that I have road and examined this application and know the same to he true and - <br />correct. All provisions of laws and ordinances governing this type of work will he completed - <br />whethor spoe/Ged heroin error The granting of a permit does not presume to give authority to ZE(c�5 <br />violate or cancel the provisions of any other state or local law regulating construction or the ,/podormance of construction. Thatt am authorized by the owner ofthis property to pedo m tho ( O -O Y Z <br />work for which application is made and I comply with the State Contractors Low 10 27 RCW end <br />296.200 WA13 <br />signature Dale <br />f Mlfs!C zgvwofa <br />,c <br />