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AUG-06-2013 13�4� <br />ELECTRI—CITY � 425 672 6799 P.01i01 <br />� <br />�a� ���� <br />ELECTRICAL PERMiT /aPPLI�ATION <br />CI7Y OF EV�RETT P�RMIT SERViCES <br />3200 CEDAR STREET, EV�R�Ti, WA 98201 <br />�25-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPUCATfONS Ai�E ACCEPT�D FROM 8 AM TO 4 PM <br />_�,.i- �U ��.� . � ��E_�e,�-{�� <br />PROJECT ADDRESS <br />1 t �, ;N, <br />� ��k^._ ��� �� i . � ,rc�. <br />Owner MaiE Address <br />1 ��� I �-I � � � <br />Tenant <br />� <br />���. <br />MaIE ,4adress <br />Electrical Confractor Mai! <br />�.��e Tz�� //� <br />State Lieense Number <br />C��vc� <br />Proposed Use of Building <br />City <br />�J .s o�^ s�--�� <br />Description of Work to Be Done: u�__�_�( `�j �l.0 t'� C <br />NOTE: WERING iN NON-nWE�LINGS IS f�EQUIRED TO <br />B� IN f�AC�WAY5, MC OR AC CABLE . <br />city <br />Ciry <br />� <br />State/Zip Phone <br />�h�i- 2� ��3 ,S�'� <br />St3tEl7_ip �nane <br />�� �dS/7��� ; <br />State/zip Ph� <br />f ��d <br />Contracf Price of Work <br />`��,�� .�.� <br />Contact P�rson (P3an Review} <br />� f <br />S :�� �J�`'�_�(I � (�t� <br />Cl7Y OF EV�RETT LOCAL 5ALE5 TAX CODE IS 3105 <br />f l�eroby certify U�at ! have read �nd exarnined this application and knaw the sarne to t�e true and <br />correct. A// provlsrons ollaws and ordinances qoverning thrs type of work will be completed <br />whethe� specifred herein or not. ihe granting of a permrt does not presume to give authority to <br />violate or cancel the provisions of any othcr stafQ or loca! law rggulating Constructran or ihe <br />perform�nc¢ of constructron. Ti�at I am authoriz.ed by the owner �f tfiis property fo perfonn the <br />work for which a/�plication is made and I comply wiih the State Contractors La�v 18.27 RCW and <br />296.200 WAC. <br />FEE <br />����;. <br />�,'` � g--� <br />�I���;� <br />��'e�e ���e Z� �C� C�7��� �I,�- . �i��'�1- / <br />G�� G� <br />TOTAL P.01 <br />