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10-01-15;08,50Ah�;From; <br />To;4252578857 ;4257413521 # 1/ 1 <br />ELECTRICAL PERM�T APPLICATION <br />CITY OF EVERETT PERMlT SERVICES <br />3200 CEDAR STREET, �VEI��TT, WA 9820'! <br />425-257-889 0� FAX 425-257-8857 - www.everettwa.gov <br />� <br />. <br />.�.�d i�l t�( �` �)'� � S ��✓- �V' ' � �LilQi��' ,� 1iV"� ��� <br />PROJECT A�DRESS <br />�n Sv <br />Owner <br />VV� <br />Tenan# <br />Y� n-, 23� �ti1.�i ��,�� �2T �,�,W'o1 �Q-��, �� <br />iVlail Address <br />Y�L��� �' <br />Mafl Address <br />s�r,��re.� ts��� ;�r� ,t�r, i� <br />NEaif Addtess <br />' �f' Q �j ��i��.t2.�,En+i ��13 6 �' <br />State License Number (requir d) <br />L�'GY�viGi�c;:/ L�c:c� <br />Proposed L3se of Building <br />Cify <br />City <br />�,� ►��w��� <br />City <br />�° � 711 S <br />w�- `��z��' <br />State/Zip <br />StaYe/Zip <br />Phon9 <br />Phone <br />��� �'� �i^�� <br />Sfafe/Zip Phone <br />b�/ � - O�c� <br />c�cy of EvereK Business L[cense Number (requ�red) <br />� ��o <br />Contract Prico of Work <br />���� _��x 7���-1 �ZS��`� I -3S'�� <br />Square Footage (If residenti�f new construction, remodel or addition) Contact Person/C ntact Number/Email <br />Number of devices (If tow volfage) <br />Description Of Work to Be DOr1e: �,`fS WG�� V�1���`=� �� �-�.-�1J U�� �[ J~ I���� "�i- �� <br />CI'TY OF EVERE7'[' LOCA�. SALES'i'AX CO�E IS 3�05 <br />l hereby certify that l have read and examined this appl/catlon �nd know the same to be true and <br />correct. A/1 pmvisions ofl�ws and ordinances governing this type of work wl/1 be completed <br />whether specifed herein or not. The granting pf a permit does nof presume to givB authflrity to <br />viol8te or cancel fNe provisions of any other state or local law regulating constructron or the <br />performance of construction. That l 8m authorized by the owner Of ihis proporty to perform the <br />work for whieh spplicafion is made and I comply with the State Confractors Law 18.27 RCW and <br />296.200 WAC_ _ <br />i � �� �� S� <br />REV,SE� a6�0.�10,4 <br />F�� <br />� �� ,�,,��% <br />PERMIT# <br />E 1� I �- Ccy� <br />