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05/10/2013 FRI 12:00 FAX 425 996 6501 Sca-Copy (dij002/Of: <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 - tvvrw.evereltwa.org <br />?� U P)Lk <br />PROJECT ADDRESS <br />C'a6c,12' ,.�L �'J t c;IE(,��e <br />��e���i <br />w�1 �sda Ala; a�6c it, <br />Owner Mail Address <br />City <br />Slalelzip Phone <br />( :0' M :vtiFc. 3k (s14, )at,'t <br />-1:)5 3SScvi& <br />Tenant Nail Address <br />City <br />Stateft Orions <br />1)hed -S(;dc 4-\Jcu i(- 3051 Eyf't, <br />rim g8-61 4a5 JUo5a) <br />Electrical Contractor MAN Addross <br />City <br />Slate�ltlp Phone <br />r <br />Slate License Number <br />Contract Price of Work <br />Proposed Use of Building <br />Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />I <br />Number of devices (It low voltage) <br />Description of Work to Be Done: C�d CcLAo C(: <br />'lcrlli r'C'd) 6%, <br />-'to {.N.IS (t <br />1Y' rt'. l'�ill�Ct (� ..liLf�ill r�A -P4, C.LV-ICL <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 j d eA 4 I <br />1 hereby certify that I have read and examined this application and know the same to be true and _ <br />Comet. All provisions of laws end ordinances governing this type of work twit be completed <br />whether specified herein or not The granting of permit does not presume to give authority to PERMIT# <br />violate or concel the provisions of any other state or local low regulating construction or. the <br />perform lice orconstructi . That I am authorized by the owner of this property to perform the <br />work fo which,9 icati yynis made and I comply with the Slate Contractors Law 18.27 RCW and <br />e <br />REVISED liar] <br />S•-1G-t7J <br />