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05/02/2015 13:12 360658817 WHITE SECURITY S PAGE 01101 <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.everettwa.org <br /> • <br /> 120 \A nh zo-e, . <br /> PROJECT ADDRESS <br /> 2o�r \2-D 120 vv QAC nd 7Of\ &re-tan �J X204 <br /> Owner Mail Address City State/Zip Phone <br /> OlYne <br /> Tenant Mail Address City State/Zip Phone <br /> W\-Z- Sk ' n, IL s " . • 1Z�I. 1Og-*pit ' '' �' 1n <br /> Electrical Contractor M •dress City State/Zip 0-'4123 <br /> State License Number Contract Price of Work <br /> • <br /> Proposed Ude of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> 7 <br /> Number of devices(If low voltage) �y rte/ <br /> Descripti of Work to Be.Done: �n ..._._,I..-7A <br /> k L1 13 cll`• f al S i r2-poo k o rC� V) <br /> I -A Y C 'k11$ fl ' I Ito - te2 '- - -e ace <br /> yea G . o\ - <br /> FEE �y�-� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3108 L 5 W <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. Ali provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or canoe!the provisions of any other state or local law regulating construction or the D OQ <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> • ; .C, <br /> hA� YY1 (N)i--i @v2-- 15 <br /> nature <br /> • Date @s- <br /> ���/'�' <br /> FEV19FP 320N3 <br /> PeCiae, Cu t I. q2s-',4-02-03(oto c pcYnn <br />