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07128I2015 14:14 2532882156 GARNER ELECTRIC PAGE 01�02 <br />u <br />�I�.�����1���� �fp" ���1�II�� A ��"" l�"" �������./�'1! <br />C��� �� �v��.��� ����N� �i������� <br />3200 CED�R STRFFT, EVCi�zETT, WA 98201 <br />425�257-as1 O� FaX 425-2�7�8857 - www.e�rere�tw�.org <br />,�,� � ( � G � . � - <br />�R0.1�CT A�Dl��SS <br />Ownar <br />Ton�nt <br />Mall nddress <br />Mail Address <br />Ciiy <br />Cily <br />SI.aCo/Zlp <br />SiAfie/7_Ip <br />Phono <br />Phr�ne <br />~ iP����. �����`� ��,.� �.��.�. �,� �� ��.� �=�z- asr _ <br />EleotriC�l ContraC�:or M�il /�ddress G�4,y Stol.e/7_Ip Phon� <br />�� dQ—��-����� .�J.,�--�� q' - <br />St;ato I_iccnso Number {required) Clty of Everett 13t�sinc�ss License Numbor (rEc�uired) <br />`��5 � <br />Proposed Use o�f 13��ifding Conlracl Prir,e of Worl< <br />S�uare �oola�e (Pf residential new coristruction, r�modcl or addition) <br />N�,imber of devlces (If low�voltage) <br />Description of Work fo 6e I�one, <br />CITY oF �V�RFTT �OCqL SAL�S TnX C�pE 15 3105 <br />� <br />- ` -�..31�C� -�8a� .w._ 3 <br />Contact Person/Cr�ntacl Number/�malf <br />! l�ereby certffv t1�sf ! 17ave read and ex�mJr�ed tl�is Anplication 3nd ki�ow th� samc to hc fn.�e and <br />co�/cct. All provisions of /aws arld o�cli��ancos gov�r-rzir�,q f,his lype c�f wof'/< will b� Colnplc�tod <br />wlir�ther �;pecified lrerein or nr�t. 7"he gra��ting of a permlt does naf presurne to grve aer(!>or/ty (o <br />vroJat� or cc�nco! f.hc nrovis/oris of any oihcr st�sf.c or lor,al law repu/a(ins7 cons(ruc.tipn or f,h� <br />porformanr,o o�consirc�.r,lir�n. ihat ! er�� authoiizr�d by (he owner� of tl�ls properly to perlc�rm (l�e <br />work fbr wl�lch appliration is made and 1 comply wr'2h tho St��te G'ni7irar,to�:s !_�w 98.27 I�CW anrl <br />r,svr�ar-n onmcnn i�l <br />� <br />9���c <br />r-rt `.�'.��� <br />�-\. � � � ; <br />PCRMTT��t <br />� � ���� ` ��' � <br />