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62112f2615 69:35 25328�2156 GARNER ELECTRIC PAGE 01/04 <br />ELECTRIC,AL P�RIVr�T ,AP�LICATION <br />c��rx o� �v���rT P�RnnN-r ���v�cE� <br />3200 CEbAR STR�ET, �V�R�TT, WA 98201 <br />425-257-8810 � F/dX�25-257�8857—www.everet#wa.vrg <br />�o� c� l �r�� i�1 � _ <br />PROJ�CT ADDRESS <br />Ownpr <br />Tenant <br />�2"►" _�� �� <br />Mall /�ddress <br />M�if Address <br />Clty <br />Clty <br />� <br />5tate/Zlp <br />stateiz�� <br />Phone <br />Pl�ono <br />� � '" '�`� ?��- � � ' Z� G�l <br />Electrica� Contractor Mail Address Gity StAte/Zip Phone <br />�� ��l/r - ���(D4 k,�3 <br />State Licenso Number (required) � <br />Proposed Use of Buildirrg <br />Squaro �'ootage (If residen4lal new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVER�77 L.00AL SALES TAX CODE IS 3105 <br />����� <br />City of Fverett Busineas Llcense Number (required) <br />� �� � <br />Contract price of Wofk <br />3�i� �P�.�� �o- � 2�SG�3 <br />Conlact Person/Contact NumbeNEmail <br />�.c::r� <br />1 hereby cortify tl�af I have read and cxamined rhls applicafion and know the samo ta be true and <br />correct. All provisions of laws and ordinanccs governing fhls fype of work will be completed <br />whother specifled here/n or noi�, The granting of a permft does not presume fo g/ve authorlty to <br />violate or cancQl the provisivns af any other sfate or local law regulafing consr,ruct,ion or the <br />performance of constructlon. That / am authorized by the owner of this property to perferm fhe <br />work �or wHich applicati�n is mado and ! comply with tho 5tate Confrec�ors Law 98.27 l�CW �nd <br />296,?.00 WAC. <br />RcvrsFn oam�,�o�� <br />�EE <br />� � c� <br />PERMIT# <br />� 1'�U Z - (�°I �{ <br />