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07/2812015 13:38 2532882156 GARNER ELECTRIC P�GE 01102 <br />�LECT��C,//-�L, P��.IIJ���' ,A,PPL�CATNON <br />�ITY O� EV�N�.��"T PERl111NT S�k�V�CE,� <br />32d� C�DAR STREET, �V�R�T7, W� 98201 <br />425-257-8s10 - FAX 4?5�?_57-8857 � www.everettwa.arg <br />PROJ�CT ADDRESS <br />Owner <br />Tenant <br />Mall Addrpss <br />Mo11 Address <br />CIt�Y <br />aty <br />��..�'`�LJ " <br />State/ZI� <br />5tate/7_ip <br />,_ �'�i <br />f'none ; <br />Phono <br />�'i� �v� r ��aJ-n� 22.42�5 �'-�2 `� �- � .�P..�� ti�R- �� 2 �'_S�-��2 (0�51 <br />�(oCtriCa! Contf�rtor Mall Address Cify St�tel7'i�i Phone <br />_��� `s � IC _ _ W �/J�� ) V l .]�C..�� lr1 � - - <br />S4ate Licenso Numbor (r�quired) Ci� f Gvore#t C3usiness Licenso Number (requirEd) <br />l� �a <br />proposed Use of Bullding Contract 1'rice of 1Nork <br />Square Footage (If residential new construction, remodel or addition) <br />Numbor of devlces (ff low voltage) <br />Description of Work to Re Dono: <br />CITX OF �VEREl"i LOCAL SALES TAX COp� IS 3�105 <br />�a,u.� ��� � �� ��� <br />Contact Pers n/Contact Numberl�mail <br />1 her�eby eertlfy tHat 1 hsve read and exam(necl this appliosf.ion and know fhe same io be true and <br />correcf. ,0./1 provisions of laws �nd ordrnances govErning this fype of work wiil Ge completad <br />wh�tf�er sper,ifled hereln or nof. The granting of a permlt does not presume fo glve authori(y to <br />vIolate or cencel tho provisions of any other sfate or loc�l l�w r�gulatfng constr,�r.t,ion or the <br />pe�formance of construction. Tl�at I am autl1ori�ed by the owner di tf�i.s property fo /�erfbrm fl�e <br />work for whlch applfcaf,lon fs made snd 1 comply with tho 5tate Contractors Law 1 H.7,7 RCW and <br />29a.20o WAC. <br />REVISCD 00/OB�70}4 <br />FEE � <br />� ��� � <br />c <br />PFRMIT# <br />���V�_�I� <br />