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06/18/2013 THU 13: 08 PA% 625 986 6501 Sea-Copy m002/002 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX a?5-?57-8857 —www.everettwa.org <br /> �iCi� I `.� l::.V-t.��i' r'('.� � �C1, . , <br /> PROJECT ADDRESS <br /> l�.:t't�C.l b��, � �`.�l^. i'lf.l ��< I�C% I�xi�- I'!'Gil C�Ci IC_ I �t..i'�rJO✓ 6'vll �1�i<) ) -� l.hGls�l�l�l `.7e,L I <br /> Owner Mail Adtlress C�ry Slote/Zip Phone <br /> �U`' � '�' C�, ��.,Cti C.� ��ll� JII�`.� �:.Vti.1, \�. t.U`1 vii-� l%;�{'pl'�"� �U�i ���UJ�! �) l .JI/�J��l�A� - j��c� <br /> TenOnt �dailAtltlress L ._ iry Slale/Zip Phonc <br /> � lii�{�i .��„ � �i �1.ti.� � .jG�i E l� �'U . �.'ti'IILNI bJ)'1 `i�C°)-1 � `'�:)�. �1f l� �yc;i.> <br /> � �( � li ct. e:. ) � � <br /> Elecincal CoNractO� A1ail AtlCress Cily Slale/Zip Phone <br /> . i ��11 �� � G L . ��/ J <br /> r1 i..i..i i: ..��J`��°�,�5 i� <br /> Sta1e License Number Contract Pnce of Work <br /> i�, C✓ fY1L;.;—IuIP.-J.. <br /> Pwposed Use o(Bei!ding Contact Person (Plan Review) <br /> Square Foolaqe(If residential new construction, remodel nr adddion) <br /> � <br /> Number o(devices (It low voltage) <br /> Description of Work to De Done: . �-i�L�i �v U � ��Ci- "�. 1��{�./�l(.r'-(:�- L��.•�'Vl('-i'����. �' �v��YL;�� CIV� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 r D W <br /> I hereUy ceRrty thal 1 have rcaU ond cxamined fAis applicalion and kno�v Ihe snmc 10 hn fruc ond ✓ <br /> conecl. All provisions o/laws and ordinances goveming fhis type of r�ork will be comple7ed <br /> whelher spocified here.in nr nof. Tlre granfing ol a pemtit does nof presume fo give aufharity to P[RMiT; <br /> violale or cancel Ihe provisions of nny other s(nto o�local low regulaLhr�conshuGion or fho E � 3 u 4 �3 3 <br /> pedorrn hce o/consWcfion. That 1 am au(Ironzed by Ihe nwner ollhis property fo peAonn(he <br /> woik! r vhich app/ication is maUe and I comply with(he Sta(e Conlractors Law 1827 RCW antl <br /> 29620 WAC. � � I ( <br /> , � �� � '�;� �=�'1,C�� U�� I�' _I � <br /> � i nawr? �- Dale <br /> - _!i <br /> ar:v�SCD.1.0'IJ <br />