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Jul 11 2r15 1143W N e t V e r S a n I Solulin -S N') 3206 P I <br />- -Ab--- <br />i <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 everettwa.yov <br />-2 - /-7-15 <br />�3003 GJ �r5%tea �D �6 , Z3 <br />PROJECT ADDRESS <br />1Nu?SSF_ MHII G)NRC WfW S �;�W /T q&,1g <br />Owner Man Address City Siale2,p Fr,onn <br />.1 N3 tJ G9�t'tio ep ,�VE2t Z'T G✓� ��_ <br />Tenant Met Address City Slaletzip <br />NEyelz"N r Z�,uVOK's 103aTNG�`fHs hy� sw r„�„ r k,Pir <3' eo'!r?`% <br />Electrical Contractor Ilan Address Ciiy S16104p Phone <br />gy 7 <br />tate LUcense Numb�er� (required) City of Everett Business License Numoer (required) <br />alfAMEV-G\LA'=L� gq�,060y '— <br />Proposed Use of Building contract Price of Work <br />C ► fw�E��rEIE� d> -??I- ?/; <br />Sauam Footage (If waidenlial new construction remodel or addition) Con el PersonlContael NumberlEmail <br />Number of devices (If lowvollage) / <br />INS 3 &J2/ 6 G _ <br />Description of Work to Be Dnne , AL [- /7 % !Ow .�_ rC?(� /i <br />FEE <br />n <br />CITY OF EVFRFTT LOCAL SAI.FS 7A% CODE IS 3106 <br />I hereby certify that I have read and examined Ibis applicatlod end know the same to be true and <br />correct All provisions of laws and ordinances governing this type of work will be completed <br />�—— -- <br />whether specified herein or not. !ha granting of a permit does not prosume to glue authority to PFRMITIY <br />violate or cancel the provisions rd an a othor sfato or local law hegulalmg construction or the <br />performancoo/construction Th of I am authorized by the owner of this property to perform (he E (w�7_/Z7 <br />work for which application is made and I comply with the State Contractors Law 18.2) )I end / 1 L <br />296.200 WAC. <br />zSipnarwo Date <br />aoe:ar! <br />%G <br />z? <br />