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05/31/2013 12:41 4254854320 HILL ELECTRIC PAGE 03/03 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CFDAR STRELT, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa org <br />S-3l - )3 <br />��oo W CaStno � <br />PROJECT ADDRESS <br />Owner Mall Addr us City State2lp Phone <br />[-)�2iAicn-Te4rutal Se-NiceS 31x1 lo9144"Zt5IW r=ix*e+'( U/ft 98koa <br />Tenant Mail Address City Slate/Zip Phone <br />II I:leC+roc. LOT F6176. iol\ <br />Electrical Contractor Mail Address <br />flLUGC,�oy5Q9 <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />4%oUal"xit l IA/4 9802" -- <br />City State/Zip Phopa <br />%—000 00 <br />Contract Price of Work <br />Contact Person (Plan Feview) <br />I hereby certify that I have read and examined this application and know the some to be two and <br />correct. All provisions of laws and ordinances governing this type air work will big completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions orally other state or local law regulating construction or the <br />perfomtance of construction. That I am authorized by the owner or this property to perform file <br />work for which application is made and I comply with file 3fate Contractors Law 18, 27 RCW and <br />J86.200 WAC. <br />3 <br />OEWSied4Wq <br />FEE <br />IUD -5 0 <br />PERMiTB <br />3ps - l77 <br />