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JUN-18-2813 10:55 FROM:20YER E�CTRIC 2063674575 T0:14252578857 P.1�1 <br />r �� <br />EL.ECT'RICAL PERMIT APPL�CATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STR�ET, EVEREi'7, WA 98201 <br />425-257-8810 - FAX 425-257-8657 — www.everettwa.�rg <br />� V� i�� <br />PROJECT AQQR�SS <br />��? loL�S `�j � <br />� Mell Add <br />� �5 <br />TenaTtt Nlail Ad ss <br />c-, .., n . �_ .._ , <br />��@Ct�ICB� <br />Mail AtldrIIas <br />� �Z 1��1_ <br />State License Number <br />Propose4 Use of Building <br />Square �ootAgo (If reaidential naw constn.iction, remotlel or addition) <br />NUmber Of tlevices (If low vOttag6} <br />Ciiy <br />� State/Zfp <br />�1 <br />s�r�z�p <br />P�one <br />Phone <br />- 1� �- r�,�(�) ��7-�:.� <br />Clty State/Zip PI10f16 <br />��� �/��� <br />F�., <br />Contract Price of War1c <br />��.-�-CJ �\ � <br />Contact Person (Plan � w) <br />CITY OF EVERE7T I.00qL gALES TAX CpDE IS 3905 <br />! hereby ceRif}• thet 1 hAve need end ex&minBd this appliCetion end k��ow lhe seme ta be true and <br />co+�act. AN provisions af laws end o,d;nnncas govemi»g this typs af woric wi!! b� comploted <br />whether specl�ed hereln or n0t. The granting of e permlt does nof presume to give authority to <br />vlolate or esncel tng prp�isions of any otner stete ar Ioc�l !aw regulating constrt�ctlon or the <br />perfom�ance oi �a7strvction. That I am authoiized br lhe owner of thi.s praparfy tv perfom► the <br />wprk fpr w1�lch epplication is moda and I contply with fhe Stalo Confroctors Law 18.27 RCW end <br />n� <br />F�E <br />� �- � � <br />PEi2MY'f# <br />E �� -3 �� � , � C �. <br />