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JAN/Z8/2016/THU 07: 29 AI�4 Greern��,�ood Heating FAX No. 2f]6 4��2 ���21 G P, 0[11/001 <br />LECTRICAL PERMIT A�LICATION <br />CITY OF EVERETT P�RMIT SERVIC�S <br />3200 CEDAR STREE7, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(�) everetteps@everettw�_gov � www.everettwa.gov/permits <br />��-. _� _� - ' <br />'. � .�0�'�`�1c7IN�c�kr�naTioN . ;, <br />. � . . . : , , . .. ,. , .... . .. . . , . . . . ;, . � � <br />NAME: L9� �fY��YI� L`?.. '.f.�—JZ;�s TENAN7 NAME <br />MAILING ADDRESS: srReeT 9 �-1 1� d.�Ca�{• V� s0 <br />C17Y j�,r ;�°�" STATE � ZIP �-� �. '1 � <br />OWNER PHQNE: � '� • ,�, � � �� .� OWNER EMA�L; <br />.. _ .... . ... . .... .. .. .. . <br />CON7F2AC70R NAME: �� � � , - ,,,y��� ��I [+ �—/2 <br />CONTRACTOR ADDRESS; sTFtE�T Sr'S � � � C •'�7.a r . , ('' � <br />aTv .52'l�«.�—T7� — gTAiE �iU�' zi� ��i��i <br />CONTRACTOR PHONE: '° '' '=' " �' :' � CONTRACTOR EMA1L: <br />R LIC. #(REQu�RE�) �j - ���y ,�s;N (� � yv�4,Q cinr oF �V�RETT 8LISINESS LIC. #(�EQuiu�� : ,+ � ��, L <br />CONTRACTO . . . , ._ _._ . ..... ... ... ..... .... ...... . . .......... <br />. . . ....... ... . _ . . <br />PRIMARY CONTACT: [� p�/�/��� �• ONTRACTOF� ❑ OTHER (Please Specify) <br />CONTACT NANtE: COiVTACT PHONE: r:; � �-� �� � , <br />�o'� ���,� �j y� CON7ACT EMAIL: •rA <br />" Y 'L �% � <br />u " ^, <br />�GRE�M�NT,- T hereby certlfy that ! have read and examin thls spp!lcatlon and know the same fo tre true end correct. AI! provfsiona oflaws and orrltnances governine this <br />type of wark w;l1 be completed whsthsrspsci�red hsrein or n, ThB gran�ing of s permli does noi prssume fo gfve oufi�ority tn violate or cancel the provisions of any othsr stete or <br />loca/ Ia�v rsyula[ing construction or ths psiiormanco of construePlon. rhat l am autnorizad by the �wner of this propart�• fo perforn� ti�e �vurk for whlch applieefion is made e�d I <br />comply with Ehe State Conhactora Law 18.27 RCW end 29fi.200 WAC. <br />Clty of �venett offcial Use Only <br />FEE <br />/t' �� c� <br />PEF2MIT # <br />E ( �� C� I --1 �7 �l <br />{Rmvissd >0/12/2015J <br />