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SEP/18/2015/FRI 05:45 AM FPI Seattle FA� No,4252909600 P,001/001 <br />EL�CTRICAL PERMIT AF��L�C,ATION <br />C�TY OF �'VERETT PERMIT S�RVICES <br />3200 CEDAR STR�ET, EV�RETT, WA 98201 <br />425-257�8810 - FAX 4�25-25i-8857 — www_everettwa.org <br />`3� \� Ce.�� <br />pRo.►�cT AooR�ss <br />ow�er <br />7enant <br />Mail <br />L� C,c.��.r' �N.�e.'�' UPr a.� <br />City State2ip <br />�� 1Q c <br />City State/Zip <br />Phone <br />Phone <br />�� r�.. Q��2-Q.,'� �r� � �X �?�e4Z �'�1�1 E.9� "r�`ZS� � "�C�b <br />Electrical Contrector Mail Adciress City State2tp Phone <br />'���J �_QZI _w__��- . ...,. 03�556 �`-1 <br />5tata Licen�e Number (required) City of Everett Business License Number (required) <br />��� � � � ��c� � <br />Proposed Use o� Buil ing �� � Contract Price of Work <br />��n� �J Act� �a,�, �'�5��'e)d�s.. c <br />Square Footage (if resi�ientlal new construction, remvdai or addition) Cont�ct Pe n/Contact NumberJEm i���� <br />�--C> Y � 11' �l� � �Cl.i�"�. � <br />Number of devfces (If low voltage) �� <br />Descripiion of Wofk to Be Done: ����`� d���j �_� W�,� ���� ��4 Q�` <br />� t.2.,� -P-e�Cl <br />CITI( OF �VER�iT I�OCAI� SALES TAX COD� [3 5105 <br />1 hereby certify fhat l have read and examined thls appllestlon and kr�o+v the same to be true and <br />correct All provislons oflaws and ordinaRces goveming this fype of work wi!! be complefed <br />whether speci�ied herein or not. The granfing of a permif does not presume fo c�ive authorlty to <br />vlalste or cancel the provisions of any ofher state or local law regulafing co�struction or t1�e <br />perfi�rmancs of constructfon. ihat I am aufho,ized by the owner of thrs properly to perform the <br />work for which applicatia� is made And 1 comply wltH the State Confractors Law i8.27 RCW end <br />298.200 W,4C_ <br />R�V13ED o8/Oei%014 <br />FEE <br />�2�2-��� <br />PERNIIT# <br />EI� D�'1���� <br />