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OZ�O6�Zp1Q THU 15:02 FAX <br />� <br />� <br />ELECTRIC�►l. PERMIT A�PLICATIO�V <br />CITY OF EVERETT P��tIIAIT SERVIC�S <br />3200 CEDAR STREET, EVERETT, WA 9B201 <br />�25-25�-8810 - FAX 425-257-6857 — www.everettwa,org <br />1111 80th St S'VV Everet� Wa 98023 STE 200 <br />PROJECT ADDRE38 <br />�ooa/o�7 <br />Jamco 1111 80th St SW Everett W/98243 <br />OWner Mail Addrass City 5tateJZlp Phone <br />J"amco 1111 SOth St SW E�exett W.A/98203 <br />Ten�nt Mall Address Gty Stete/Zlp Phone <br />La ht Doctor LLC 2�706 66th Ave 'W' Mountlake Terrace WA/98043 425.481.5041 <br />Clactrlcel Contractor Mall Addreee Clty State/zip Phone <br />.I��G��'I�L954L8 <br />State Llc�nse Number <br />W arehouse <br />Proposed U6e of Bullding <br />Square Foot�ge (If resldentlal new constructfon, remodel or eddltlon) <br />Number of devlces (If low voltagB) <br />$7,198.00 <br />Contrect Price of Work <br />Contact Person (I'lan Revlew) <br />oesc�iptio� ofwork to ee �one: Retrofit to Existine Light F'ixtures _ <br />CIiY OF EVERETT LOCAL SALE$ TAX GODE IS 5105 <br />/ he�aby certlfy �hat I have rBBd and 9xar�lned thls appRcatian and know the same to be tiue and <br />correcf. All provlSlonS o(laws and ordlnances goveming fh/s type of work wl!! be completed <br />whether speclflad hereln or not, The grenffng vf a permit does not p�sume to give aufhorify to <br />vlo/ste or cance/ tha provlslons of any Olher sfate or foca! law regulafing construcfion or tho <br />perforrnance of constrt�ction. Thaf 1 am eu�honzed by the ownar of ti�fs property to perfonn the <br />wo�c for wh/ch a�pllcatlon IS made and I comply wlth the State Contractors Law 98.27 RC W and <br />dn <br />REVISED 3l20/!3 <br />FEE <br />2 CU� `x� <br />PERMIT# <br />E ��1;2-C�'yQ <br />