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02/24/2015 15:14 4254854320 <br />• <br />HILL ELECTRIC <br />• <br />PAGE 02/02 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857—www.everettwo.org <br />?-(PC)U w t: clsro IV - <br />PROJECT ADDRESS <br />Owner <br />Mall Address <br />E/502 —/7/ <br />.2 -as-is <br />.^.lily State/210 Phone <br />Je.(yLPn 2CocC) W CA2,y\O ?ck 1-72�-Ut{ <br />Tenant Man Address city State2lP Phone <br />4111 Clectr.r� L-ror,rC-t-UA PC 8M /OCIS� <br />Electrical Contractor Mail Address City SWeZo Phone <br />�J LLEC-�O't TSJ <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (It residential new construction, remodel of addition) <br />Number of devices (It low voltage) <br />Description of Work to Be none <br />CITY or CVCRETT LOCAI SALES TAX CODE IS 3105 <br />03,Iso� <br />City of Everett Business License Number (required) <br />,$ 212Ov <br />Contract Price of Work <br />Eric Qt1 t(1S-�iys'-y3 1 <br />Contact Person/Contact Number/Emoil <br />I hereby certity that 1 have read and examined this application and know the same to be true and <br />correct All provisions of laws and Ordinances governing this type of work will be 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 of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application Is made and I comply with the State Contractors Lew 18.27 RCW and <br />290200 WAC <br />REVI=090441014 <br />FEE <br />IZ(:�Sc1 <br />PERMIT# <br />E v2 1 <br />