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07/02/2014 15:14 2062�47716 <br />,. � <br />ASG <br />PAGE a1ia1 <br />FAf A �iz�ln i � i �' � <br />CA�.� �..� � C'_c. � <br />ELECT�ICAL, PEF�MIT ,Ai�PL�CA,TION <br />CITY OF EVERETT PERMIT S�RVICES <br />� 3200 C�DAR STREE-�, �VERETT, WA 98201 <br />425�257-8810 - FAX �425-"?57-8857 — www.everettwa.org <br />�O� QAG1 t � I�V� . _ <br />PROJECT ADpRESS <br />-����,�� Pa �� ����� ��g�� �� � � 3g y 2s- � ,1 � 3� d_3 <br />Owner Mall Address Cily St�telZip I�hone <br />Tenant <br />Mail Address <br />City <br />St��te/Zip <br />Phonc <br />�1,. bC�O UptiK�S� �d �tl.� :`3� �ZO�' <br />l��f.+^�c+a.� �"����'�Y ��� �4 �T� IOe�_ �rG�.% i��� ���� i 'z�s�! �35�'� <br />Elect�iCa! ContPactor Mail v,ddress City Stat�/Zip Phvne <br />�Ra�Sc� �f 3� c� <br />State License Number <br />Proposed Use of Building <br />Square Footage {lf tesiden'tial new cons#ruction, remodel or addition) <br />y <br />Number of devices (If low voltage) <br />T L F �7 <br />Contract Price of Work <br />Contac# Person (Plan Review) <br />Descrip#ion of Work to Be Done: �t�ST�I,<.. LO� V CriLTA�G� S�CI� �Ti J�' ��JYI_ ' J��-- f�J7� ! <br />�orn�s � U«co�u � /av7�sr►� 1�oa� Co�ZA -- <br />CITY OF EVERETT LOCAL 5ALE5 TAX COD� IS 3145 <br />( hereby certify that ! have read and examined this application and know th� same fo f�e true and <br />correct. A11 provisrons of laws snd ordinances governing this typE� of work wrl! bc com�letec! <br />�vhefl,er specified herern or nof.. The granfiny of a permit does not presume ffl give auf�hority fo <br />violate or cancel the provisrons of any ofher s(ete or loca! !aw t�_qulating construcrio� or the <br />performanc� of constructiorr. That 1 am t�uthorized by the owner of fhis propGrty co perform the <br />work for whfcf� application is made and f comp�y with fl�c Stafc Cnntractors Lsw 18.27 RCVV and <br />296.2Q1� WA C. _ <br />R6VlSED 3/20/13 <br />« <br />FEE <br />(� C� <br />JU <br />PERMIT�# <br />E i�0� � �z� <br />�%��c_:s ��'� Y� �.�-�,� ��x 2��• � :��y.. -7•� d �.ry <br />