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Apr 10 15 02:30p <br />� <br />� <br />ELECTRICAL PERM�T APPLICATION <br />C�TY OF EYERETT PERMlT SERVICES <br />3200 C�DAR SiRE�, EVERETT, WA 982p1 <br />42�257 88't0 - FAX �2�257-88v7 — vw+�v+r.evefef�nra_nrg <br />13�q <br />PROJECT ADDRESS <br />Owner <br />Ten ant <br />��� <br />Electncai Con'tractor <br />��c��t� �u � <br />=�-�� �� <br />' Mail Adtlress C� <br />� K..� <br />State/Zip <br />rusan Atldress ��y <br />StaielZip <br />� <br />C N C�i�JS iP��e�, A� ��vr�� ��.� <br />nnau naaress <br />I��� � I ! ��7� <br />5iate �icense Number (req�ired) � '�� <br />T�,�-- � .� <br />Proposed Use of BUifdrng <br />Square Footage (if residential new construction, remodel or additian) <br />� <br />I�iumber of devices (�f low valtage) <br />City <br />StatelZip <br />p.1 <br />Phone <br />U� one <br />����� <br />Phone <br />d�-5f4 <br />City of Everett Business License Number (required) <br />� ��'� <br />Cor�tract Price of Work <br />�8 U2� ?v� �-F 1.�� 3 �= <br />Contact Person/Con#act �iumbedFinail <br />DESCiIDtjOn nf Wnrl� tn Ro n....o- ��� ��� l l(/V , F � <br />.. ` • _ —_— �� <br />� . ��..� � _ - <br />CI7Y QF EVER�TT �OCRZ SA«5 Ti4a( CDpE fS 3tQ5 <br />I here6y certify ihat 1 have read and examined this applicafion and Imo�v ihe same to be true and <br />corr�ct AI/ provisrons ot lavrs and ordinar�ces govemrrrg fhis fype of work wr7� be complefed <br />whether specified herefn or not. The granting of a permit does not presume to give authonty to <br />violate or cancel the provisions of any otherstate orloca! larv r�gulating corrstructiorr or the <br />performance of constructiQn. That 1 am authorized by fhe owner of this pmpe�ty to perfarm the <br />work fo� which applicafrorr is made and ! comply with fhe State Cornractvrs l�r,y T g.2T RCUf/and <br />296.200 WAC. <br />REVISED 08A0.2p14 <br />FEE <br />� �� o0 <br />PERMIT� <br />E i���-0(��' <br />