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MAR-24-2014 02�37 POSTNET MILLCREEK <br />4253160608 P.01i01 <br />ELECT'RIC,AL PERMI�" APPLICAT�UN <br />CITY OF EV�RETT PERIIIlIT SER�/ICES <br />3200 C�DAR STR�ET, EVERETT, WA 982D1 <br />�25�257�8810 - �AX 425�257-8857 — vwvw.everettwa.org <br />`�x��� � <br />,3��,� ,/�o��� <br />FROJ�CT ADDlr£SS <br />���� � � � <br />Owner <br />'�enant <br />�lectrical Ca <br />i`l�„� ����� <br />St�te �icensa Number <br />�/�� `��v// <br />PropOsed Use of Building <br />� �, 3� <br />Mai! AddreSs <br />Mail Address <br />Mail Address <br />Square Footage (If residential new constructian, remodcal or addition) <br />Number of devices (!f low voltage) <br />Description of Woric to I3e Done� �L �/� G <br />% <br />C ity <br />City <br />City <br />�,, � � <br />�' l:�rh� ,l ' / � � � <br />d �j�Q ? �� <br />�' ��-��"�,� ����� <br />State/Zip � Phone <br />StatelZip Phone <br />:����d�x i��=x�3��d <br />State/Zip <br />Phone <br />��`� ._._�. <br />Contract Price of Work <br />Contact Person (Plan Review) <br />s/ <br />� ��t, ✓�l���, <br />�r��= � ��./� v �._ _.� � <br />CITY OF �VERETY LOCAL SAL.ES TAX COQE IS 3105 <br />I h�reby certify that I have ropd and exarnined thls application and know the same tc� be true and <br />correci. A/l provislons oi laws and o►�dinances govorninc� fhis type af work wrll be compfot�d <br />whethor specified herain ornot. Tho yranting oi� peirnit does not prosume to give authorify to <br />violatv vt cancel the pr�visions of sny ofher st�te orloca! law re�ulatin,q construction or tf�e <br />performance of canstruction. 77'rat I am authorized by the owner of fhis property to perfonn the <br />work for which applrcafion is m�de and 1 com�ly with the Stafe Contraators Law 18.27 RCW and <br />296.200 WAC, <br />�i �7"�Z <br />� Si nature Date � � <br />FEE _..__ <br />, '; � S G <br />PERMIT# <br />E I�C- �-o`� z <br />ct-v�.CFI'! 9MM1.4 <br />TOTAL P.01 <br />