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��s���z <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CFDAR STREET, EVERETT, WA 98201 <br /> 425-257-881U - FAX 425-257-8857—www.everettwa org <br /> 49181=0Ri•:ST DR <br /> PROJECT ADDRESS <br /> L[��I�A Rf�11:S'fAn �1918 FOR�S"C DR I�.VIiRE'I'7' �yA. 98?03 425-252-�1012 <br /> Owner Mall Address <br /> Gty Slatc2iD Phonc <br /> Tenant MailAddress Gty Stale2ip Phone <br /> bfM COMPORT SYS7'EhtS 18103 NE 68TH ST G200 REDhtOND �1'A/9A052 425-881-7920 <br /> Elechical Contractor A"ail Addmss City State2iD Phone <br /> M�ICOMMC925C5 ;50 <br /> State License Number Contrect Pnce of Wark <br /> S'�i Ta.v�e�t}-e U�e.L�S <br /> Proposed Use of Buitding C,ontact Person (Plan Review) <br /> Square Footage(��residenlial new construction, remodel or adddion) <br /> Number of devices(If low voltage) <br /> Descnption ot Work to Be oone INtiI'AI.I, A SINGLE HEAD DUCTLE55 FIEAT PUti1P SYS'I G;vt <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 31D5 e��(\ v� <br /> `P'✓(J <br /> 1 hereby ceRily!ha(1 have�cad and exammed fhis applicahon and know fhe same to be truc and <br /> conecf. A!I provisions ollaws and ortlinances goveming lhis fype ol work will be compleled <br /> whefhe�sper.ified heiein or nol The�ianfin�01 a pennif does nol presume fo Qive aufhonty to PERMIT# <br /> violafe or c�ncel fhe provismns ol any other sfa�e or local law regulating wnsfruction or fhe �I � A � o�� <br /> peAomianr.r, ol consLvction. f I am aulhonzed by fhe owner ollhis propeAy fo pedo�n fhe �_�`f I <br /> work!or whiclr application ' nra e and I compty � fafe Cont�actors L aw 18 27 RCW and <br /> 296.200 WAC. <br /> 9/l/15 <br /> Sig al e Datc <br /> acvisFo�.nn.t <br />