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O1/21/2014 12:26 FAY 42535�8934 Evergreen Security . <br />� � <br />ELECTRICAL PERMIT APPLICATIQN <br />CITY OF EVERETT PERMIT SERVICES <br />32Q0 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www_everettwa.org <br />, � �'S ! � `'pG��C'-��C,- �1�. <br />PROJECT ADDR�SS <br />�002 <br />Y �Co�S '-�-� ��l'� �' C%c� <br />.�,.,, <br />OWi1el' M211 AddrOss Ckty SCetelZip phone <br />Tenant <br />Electricaf C <br />'�IJ <br />Mail Addrese <br />Mail Add <br />� V �-�� � � �`-� <br />State License Number <br />f <br />- - 1 ' �� �� <br />Propose se of �uilding <br />Square FooCage (If residential new construction, remadel or addltlon) <br />a <br />NUmbe� of devices (If low voltage) <br />City <br />� W <br />State/Zlp <br />�{�,-3�.( & <br />City �,J Siate/Zlp Phone <br />� �+ • � <br />l� <br />Contract Price of Work <br />� <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SAL�S TAX CODE 1S 3105 <br />1 hereby certify fhat I have read snd examined this application and knaw the same to be t�ue and <br />correct. A!I prov;sians of laws and ordinances goveming this #ype of work wiN be completed <br />whether specified her�in or noE The granting of a perTnit does nof presume ta give authonty fo <br />violate orcancel the provisions ofany otherStetE orlocallaw regulating constructlon orth6 <br />perfomrance of consin,ctron. That I am authorized by the owner of this property to perform the <br />work fo� which applicetlon IS made and / comp/y with the Stafe Co»trsctors Law 98.27 RCW and <br />REVlSED 3/ldh3 <br />/ � r � <br />`� ' � �'-��h � � ~U <br />FEE <br />�D �� <br />PERMIT# <br />E ��0�- 1� <br />