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Ap r. 25. 2016 � 9: 33AM � No, 2650 P, 1/3
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<br />EL�CTR�CA,� PERMIT APPLICATION
<br />CITY OF ��VERETT PERMiT S�RVlCES
<br />3200 CEDAR STREET, �V�RETT, WA 98201
<br />425-257-8810 - FAX 425�257-8857 – www.everettwa,org
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<br />pR�JECT ADDRESS
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<br />Owner Mail nddress Gty State/Zip
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<br />Tertant Maii nddress Gity State/.7.ip F hone
<br />G&5 FI�ATING 3409 FVER��I"T AVE �V�F2ETT, WA 982�1 425-252-4402
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<br />Electrical ConlraCfor Mail nddress City SfA�@I7f�7 f'thone
<br />GSSt1TGSH939RK 019685
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<br />State License Number (req�Elred} City of Fverott Business Lic�nse Numhcr (required)
<br />REs�o�f�'r•IAL
<br />Proposed Use of Building
<br />Confract I'[!Ce of WOrEt
<br />pAWN WEfMER 425-252�4402
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<br />5quare Foolage (if residentiai ftew ConstlUCfinn, remodel oi� addition) Cor�lacl Person/Contact N��mberlFnt�il
<br />Number of devices (If low voltage}
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<br />Ooscription of Wo�k to 6p Done: L_ c�c. � I� ��d� �.L,a �..��{',�i,;.._� �!i�,
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<br />CITY OF EVERETT LOCAL 5ALE5 TAx CObE IS 3105
<br />I Irei�by ceif1fy fhnt ! hvve iead �'lnd �xamrned this t�/�{�licaflon �nd tcnvw the sHme to f�o ti��rc �nd
<br />corm_ct. /l!1 prUvislons nf l�ws and w�f/r]a��c.e5 gnvcmin,q liris lypr� of wo�lc will bc con�pleleC!
<br />wi)6li1e�'sprlcifir.rl hereir) o� I�oL Thcr ,qr;�ntiray o( y per�711t dor.s noi �resurne (o c�iVe �`re�fl�o��ify to
<br />violatc ar car�Cel fhe pmvisions of airy olher� st?fo or local I�w ie�cd�tirlg rnnsfrucfion ur' lfle
<br />per(or�lianCo nf consfruction. Th��t 1 am authoirzed Oy the nwr�cr of thrs pro�etty to /)nrform the
<br />worl< for wf�iclr ���plic�?tfon is made artd ! cwz�ply with the SlN(e Conh���cta:s L3w 98.27 RCW ����d
<br />29(3.200 WAC.
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