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`�`J'1 i \ <br /> l <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 42&257-8810 - FAX 425•257-8857 —www.everettwa.org <br /> 11120 Evergrean Way Everett WA 98204 - eLDG C <br /> PROJECT ADDRESS <br /> Coast Real Estate Services 2g2g Rucker Ave Everett W/4, 982�� <br /> Owrler �dall Atldress City SlatafZiO Phona <br /> Evergreen Center- BLDG C 11120 Evergreen Way EVE;fE'.tt �/�/A1, 98204 ""'°'�' <br /> TBnent Mall ndtlress Crty StateRlp P�one <br /> Guardian Security ��a3 F�r�c a�e��e soucn Seafitle WA, 98134 WL��°� <br /> ElectriCal Contrector Mad Address Clty Stele/Zip Phone <br /> 033443 250.00 <br /> State License Number Contrsa Price ol Nork <br /> � Building Casey Walsh <br /> Proposed Use of Building Contact Person (Plan Review) <br /> 2��� <br /> Square Footage Qf residential new construction, remodel or additlon) <br /> 1 <br /> Number of devices(It low voltage) <br /> Descnption of Work to Be Done: �nSt8��8t1Of1 Of �@aSed /a�s I'aC�lO t0 f@p�8C2 SC8f1 fT10f11tOClflg <br /> FEE <br /> CITY OF EVEREiT LOCAL SALES TAX COD6 IS 3105 r/'�� <br /> i hereby cert;Iy that�heve ieed and oxamined this epplicellon and know Ihe same to bc true and ��J <br /> correr.c An provislons of faws and orrlinances goveming fhis type o)wod�w;i!be comple(ed <br /> wh,arher speclfied hernin ornot The grant/ng ot a penni(does nof presume fo glve au�honty to PERMIT# <br /> riolate or eencel the provlsions of any other sfatn orloce!iew reguiating const/vclion or fhe r <br /> pedormance oJconsWcfiun. Thal 1 em aufhonzed by7he ownerof this propeRy fo perform the C ( 3 � I — �� <br /> work/or wn/ch apPlica6on Is made and I comply wi(h the Sfa�e Cont�acfols Law OB.27 RCW end <br /> 296.2 0 WAC. <br /> i <br /> 11 /12/2013 <br /> �a ` Dalo <br /> RfVI$ED J/25'19 <br />