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10/05/2015 10:36 4252510293 CAPITAL LIGHTING PAGE 01f61 <br />`�.. � � � <br />EL��TRN�qL PERNIIT A,PPL�C <br />G�TY OF LVEREiT PE AT��N <br />32U0 CEDAR STREET, R�, w��Zo��E� <br />�42�-257,8810 - FAK 42�-257-8857 — www.everettwa.gov <br />I� � s � S-� �►� s� w��v� ��-t�-,1�1� ��ao3 <br />PROJECT ADDR�SS <br />Qwrler <br />�� <br />Tenarrt <br />�IectriCai C�ntractor <br />_Ti� a 1C�1�-f -lk �V�? � <br />hAeil Address <br />4"`� � <br />City <br />�� a`� �- k. r �� `b1 � 7.S'� ss S w� E�� ��-�+- <br />nna�r addr+e�gs � <br />'=�`� ��3� S[u 4 � 3� � �r • �'��.�� � �n,� <br />Mail AddR9s5 �.. <br />C(� f� 1 i t- ��°�a �� <br />Sta4e l.icensg Number (requpred) <br />�X�St'�� <br />�Posed Use BUIIdi�g <br />Squane �ootage (If resldentiaf new corr.;tru�a�, �m�e1 or addition) <br />� <br />fVum�er of devlces (If fow voltage) <br />Description of Wark to Be Done: �� �Z --� <br />4��1 �� <br />�Qn <br />�ab-�3D� <br />�A �'r�le�-�h� � b8�.� <br />bY�telZip <br />�- °i 8' Lt�� <br />Phone <br />State2lp �hone <br />�� nS � �S-�� 1-oa�-� <br />Stdt�D <br />Phpna <br />V� �� <br />City of �verp� g,��e� License Number (nequired) <br />111.� tl <br />Coniract Price of Woric <br />� a� �11 c,�a I 1, �-���� w. <br />Contact eison/Contact Num� �/�m • -� <br />� � <br />Cm' Ofi �VERE7T LOCAl. SAL�S TAX COD� IS 3105 <br />���bY ��fy tha� 1 haye r�ad and exatnlned �►tis epp�f�� and know �e same to be frue snd <br />correct Al/ prbvisions of laws and orrline��ces govemfng this type of wark wfl! be com,plefisd <br />whether specified heiein or not. Th� grsr�fing of a pemrit does not presur►le to <br />vr'c�late or canc�l t�e prnvrsions of an� oth��r stare o, roca� t�,� 9�s author;ly fo <br />periarmanne of construction_ That 1 am atrflmr;zecf b the '�ula�ng constrrichon or rhe <br />wOris for ►vhich appl�Cation is mad� and ! c��mply wif the StaMte Contracto�s� w 5.�� and <br />29620p WAC. <br />�;,�Y-o I i�� <br />'��,5-,��I, t7�44 �p�on� <br />y� a.�' - a,�S' 1- l7 �.�13 ��e. }� <br />REv►SFD OB106/t0l4 <br />� �.�v --�-0 f f � <br />FiEE <br />9� �Y� <br />PERMIT# <br />� 1�( � - �2I <br />T'�ea.ce cr��,'h���- �,e <br />�� Crc ��'�' C0.c�C� <br />n��•e�.� <br />��.� <br />c� <br />C�l3Vo �1�,�(L <br />