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m <br />De�, �, 2015 9;��]AM Sound Se�urlty Ii�� <br />� � , <br />No, 0202 P. 3 <br />� <br />+, 1 <br />ELECTRiCAL PLRMiT APPLlCATiON <br />C1TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STR��T, �V,��2�7T, WA 9820� � <br />425-257-8810 -' FAX 425-257-8857; ,v,✓ww,everettwa.org <br />� � � � p � � <br />� � � �r' � r, �,ti.1 <br />�� <br />PROJECT ADDRESS <br />Owner <br />���� <br />Tenant <br />Mail Address <br />Mal Address <br />��n ��ol �a�.e�� o?.�2t� ( ��� �� r�` <br />Electrical Contractor Mai1 Address � <br />�� � � ��_����� <br />State Licensa Number (required) <br />� .� ; <br />��}'���..�r�"�"fiv ���� <br />Proposed Use of Building <br />.�--- <br />Square Footage (Lf residerltial new construction, rernol el or addition) <br />� . C <br />� . <br />Number of devices (If low voltage) <br />Descriptian af Work to Be Done_ <br />� i <br />City <br />City <br />, <br />State/Zip �r � � Phone <br />r� �� �� � ��r' <br />5tate/Zip Phone <br />��� ~ <br />�'� 1 ZS�l-_3�SS <br />City State/Zip Phone <br />I .� I �-f � <br />Cify of E�erett Business License Number (required} <br />� ��,�� <br />,' <br />Contract Price of Work <br />�. � z��� � I � �..� <br />Contact Per on/Contact Number/Emai1 <br />; <br />o�I �� J <br />J' � �I� � U �'� " V "--' V ` .� � '�.-i� � C„�. � <br />� /� . <br />J <br />�, � FEE <br />CITY O� �V�RETT LOCAL SALES 'TAX CODE IS 3106 (� (���' <br />�� l c <br />I hsreby certify that / have read and examinsd fi�is application and know tHe same fo.be true and <br />correct. All provlsions of laws and ordinances govsminy this typ� of yvork wil! be completed <br />whether specified herein o� no% The granting of a pe�mit does nof prssume to give aufhority lo P�ftMI7# <br />viol8fe or cancel fhe provisions of any ofhersfste orlocsl lew regulating consfRacfion orth� , I <br />performance of construction. rhst 1 am suEhorized by. the ownerof this properfy ta p6rform the ��j (�'�� �� �L� <br />work for which applica�ion is made and I comply with the Stafe Contracfors Law 98.27 RCW and �% � <br />296.20 WAC. � ,�' q <br />9 �� <br />' ����� , �i� �� � > <br />Sianature /� nate r <br />RGvrsEn osrosr2nr a <br />