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JUL/24/2015/FRI 08:49 AM FPI Seattle FAX No,4252909600 P,OOi/001 <br />� � <br />�iL�CT�tCAL ��R�li A�P�i��►T'ION <br />CITY OF E�/�I�E�'T PER11�1� ��RVICES <br />3200 CEbAR ST�2EET, EVEI��TT, WA 88201 <br />425-257�8810 - FAX 425-2�7-8857 - www_everetfwa_org <br />,-, /� l:�-�.. <br />���� ���,�� <br />, _� , .._. ► t n . <br />PROJ�C� AE?DR�SS <br />� �V .�hl� <br />�_ <br />(�as) <br />owner 5�2 . l9-e� Ct� �� S�}� <br />Mail Address ily State/Zip Phane <br />��S C`.��v°� ' �o r � � ���..5 � <br />q t � 4�b <br />Tenafit Mail Addreea City S`tate2ip Phone <br />C4�) <br />r �� � ti�� a��� 2�, �.� <br />Electrica! Cantrac#or n�at1 Adaress city State�zip Phona <br />��. � � * � �.. <br />Sfate License Number (required) <br />' �C <br />Proposed iJse of �uilding � " <br />Square Footgge {If reaidenti�f nsw construciion, rettlodel or add(tion) <br />J� <br />Number of dsvices (if law voltege) <br />Description of Work ta 8e Dor1e: <br />�� <br />CI'TY OF �V�R�TT LOCAL 3ALES TqX CODE i5 3105 <br />---�� `�S � �-F� <br />City of Everett Business License Numb�r (raquired)^ <br />�,`-xls��vy �'� ..._ - <br />Contract �rice af �/Vork <br />��Z <br />Contac� Perso Contact Number/Ematl <br />/ he�by cer�ify that I have read and examined thls app/icatlon end know the same to 68 f�e and <br />correct. All provfsions af /ews and orrilnarlces govemfng this type of wark w1ll be completed <br />whether speclfied h6rein ornot The grenHng ofa permlt does notpresulrre fo glva aufhorrtyto <br />violate or cance/ the proyisivns of any ofherstete or /ocal /e�v �gulating constructfon or tfte <br />wortc 1`or wh cft epp/ ca on�s ada and ! mply w th the Stat Cont ac�rs �ew ig 27 CW $„d <br />2fl6.200 Wq� �, <br />REv1Sk�o&�or2ata <br />FEF ' <br />',� `.., " � <br />`� ,� � �- , i"/ <br />PERMIT# <br />c � �� r/ I �� <br />� <br />