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�L�CTRICAL P�R11�l1" ,�PPL�G.�if�i� <br />CITY OF �VERETT PERMUIiT S�RVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8�310 - FAX 425�257-$857 — www_everettw�.org <br />. <br />3 a � 3 � Ps+ C�s iv�c� �� �3 � � �{ � � <br />.;--- � <br />P}20JECT ADDRESS <br />� Qe r�v��--_-�--- �� a x 3�0� S� �r �/� `'1,8 / Z�} <br />, <br />OwneP Mail Address City StatefLip Phone <br />i3��,�� <br />T�nant <br />Maii Addness <br />City <br />State(Zip Phone <br />�ri,rne ��c�r'� )3301 S� 2G�� S'� �I�vve. wfl ��5 �t�•`7��-�zr�� <br />ElectriCal ContraGtof � Mal Add�ess City Stateil�p Ahone <br />��?11�6���t3� �. <br />State License Number <br />0�-� ;�e <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodet or addi#ion) <br />__ ..._........._ _ ...... __ <br />IVumber of devices (If taw voltage) <br />Description of Workio Be bone: � I�C�%� <br />� r d s % . �"a� -#� � <br />�Gc�, 60� <br />Conbract Price ofi Woric <br />Contact Person (Plan Review} <br />�� b I�[�I �- (�� <br />� / <br />l/� `� <br />, � f rqs �-r�ae �t�, <br />Z155`fn. <br />CITY OF EVERETT LOCAL SALES 1'AX CODE IS 3105 <br />T � r � �tn ��u� 5 <br />! hereby certify fhat 1 have read and examined fhis applica6on and know the same io be true and <br />corr�ct Al! provisions of lavvs and ordfnances goveming fhis type of wori� will be complated <br />v✓i�etner s�scineci rrerein or not. 7he gran6ng of a perrrrit does not presume to give aufhority to <br />violate or cancel fhe provisions of any ofher sYate orlocal !aw rec�ulating consfruction or the <br />perforrnance of conslruction. Tl�at ! 3m authorized by the pwner of fhis prvperty fa perform the <br />work for which applicJtion rs marle and 1 compty with the Sfate Cor�tractors Law 18,27 RCW and <br />296.2Q0 W . <br />/�/d � L 0 / S, <br />KEV7SED 320/13 <br />FEE <br />� iDiSn� <br />� <br />PERMIT# <br />EI�I�' 1�v <br />