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05/3!'2013 12:41 4254854320 <br /> HILL ELECTRIC PAGE 02/i�` <br /> � ELECTRICAL PERMIT APPLICATION <br /> �� CITY OF EVERETT PERMIT SERVICES ,� <br /> 3200 CEDAR STREET, EVERETT, �NA 98201 9 5_� <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.or � -�3 i <br /> C �-3p 5..11 (0 <br /> I �3I I /-� rDOf�_d B—���`�� � <br /> PROJECT ADDRES� <br /> �N,�e� Mail Address <br /> City Stete2ip Phone <br /> 3 11-1 �O� �v' St S `/J �leret+ vJ/-� `j �',ZCi"� <br /> �iG �� �...ec.� n�c. eN tcP ab. � s�a�erz�p anopa— <br /> TenaM Mdi�Adtlress <br /> � i�� �2C�TiC. �OCp[Juo�\IU/� � � ��qs ��vtUi��P u'f� �C��Z— Pnone <br /> I Slate2�p <br /> Electrical CoMfee[O� MeA Atlaress <br /> � 3bo�c <br /> �������� ConV et Price of Work <br /> i <br /> State License Number <br /> Contact Person !Plan Review) <br /> Proposed Use of Building <br /> I <br /> Square Footage Qf residential new construGion,remodel or atldition) I <br /> Number of devices(�f low valisQe) � <br /> i <br /> IDescriptianofWorktoBeDorre: �ro��de 6�."r ��� � ` V - . .`- <br /> I -'— <br /> i <br /> I� FEE <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 � I 'S�� <br /> � <br /> 1 hereby ceRily fbat I have�eed and examined ehis appficeGon end know ihe seme ro 6e tme and __ <br /> correcf. A/l pmvisions of laws and oid�nances goveming this type of work wiU be complefed � <br /> whether specified berein or not. The grenBng ot a permit does not presume Ao give auGro�iN to PERM17# <br /> violafe or cancel Ne provisions o(any other state or loeal law re8ulating cons WCHnn or the r ��D� _ � �!�, <br /> peAormance ofconsWcfion. That I am authorrzed by the owner o(this property to perfomr the [ ��' <br /> � work Por which application Is mede and 1 comply wiN the State Contracfcrs�aw 18.27 RCW and _____.. <br /> i 29s2oo wAc. <br /> S- f- ( <br /> �q re <br /> oata <br /> � REVREDYI6'iJ ..... <br />