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Oli23i2014�09:45 <br />From: <br />� <br />�.�\\ <br />20140123�9 LIZA HAGGRRD <br />�� r p�� i C�-�� ��' 2CXo - C.2 �� S 0� <br />ELECTRICAL PERMIT APPLICATION <br />C1TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE7, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�� � l�� �� �,�� �� � �. <br />PROJECT ADDRESS <br />Own e r <br />Mail Address <br />City <br />- Paye: 1�1 <br />State2ip Phone <br />s7S�[.� �ii Gi �l�i,�� `,�f1 t Y�U � d�� �j,�S'� ��� ��e�'e.., �°Z�$ �vC'+.��} \1� '� ��� <br />Tenant Mail Address City State2ip Phone <br />? � G - bl� �' <br />� � _ `1 i b \ <br />�a` <br />Electric <br />��;.«.\ ���4�,�s 1�1�Z (pSt'h l� <br />ntractor Mail Address <br />�C � C� (� tti��. � (.o� t_�. f� _ <br />Stafe License Number <br />�".�`� i �. <br />Proposed Use of Building <br />Square Footage (If residential new construction, rernodel or addition) <br />Number of devices (If low voltage) <br />City <br />�� ��H��,,zh �„iA � K z� y, <br />State2ip Phone <br />����Q��_ � <br />Contract Price of Work <br />Contact Person (Plan Reviewj <br />Description of Workto Be Done: ��L9„�i ("�~�-�'et('p �� � y��q 1'rZ�,q���� ����,�- �,i�1a{h.g;� <br />ii,lQ LcA� C r'R..� vs2� �--7�15 11+I1A. � l U�T 1� v1s1 s�`�-C.1'�'� Cct�, C',�-3r(l �C`�'.�C��t`t�✓� '� <br />� V4���M-S -�i i��� �V� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />f hereby certi(y that I have read and examrned fhis application and know the same to be irve and <br />cor�ect. All provisions of laws and ordinances govemrng fhis iype of work wid be corripleted <br />whefher specifred l�erein or not. The granting of a permit does not presume fo give authority to <br />violate orcancel the provisions of any ofher state or focal law regulating construciion or the <br />performance of consfrucfion. Thaf i am aufhorized by the owner of this properiy to perform (he <br />work for which applrcatron is macie a»d 1 comply with fhe Stafe Contracfors Law 18.27 RCW and <br />2ss.2oo wac. <br />RC-VlSEO 3/20/13 <br />c� <br />^7 2— <br />FEE <br />� GC% . c� <br />PERMIT# <br />E (�-I-�?(- Iz-j <br />