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11/07/2013 08: 11 36079473E2 TIJTELECTRIC PAGE 02/02 <br /> i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT P�RMIT SERVICES <br /> 3200 CEDAR S7REET, EVERETT, WA 9F3201 <br /> 425-257-8010 - FAX425-257-8857—wwv�.everettwa.orfl <br /> �3 z �_ co�,►���� � <br /> PROJECT ADDRESS <br /> j���k- `f�r�5k��. ��Z�� �vm���Q � �ler'e-N-,�-��zn3 <br /> Ownar Mail Address Giry StelefZip Pnone <br /> renant MailAddre6s Cily Slale2lp Phone <br /> I V�-T ���IGr�Y �a�LyC l�� Mdlilf'c�" f � 5l� �c�Z7 Z <br /> Electricai Contractar tda�l Atldress Cily Stalo2ip Z/7� P one� <br /> .��� ��.� <br /> ��� ����� ��. � <br /> Stalo Licen6e Numbsr ConlfaCl Price of Wofk <br /> Proposed Use of Building Canl2Cl Person (Plan Review) <br /> Squara Footage(I(residontial new construclion, remodel or nddition) <br /> Number of devices Qf IowvolWge) <br /> Description of Work to Be Done: W �fQ '�i7� ���-�--� W��-5 ������'� <br /> � <br /> FEE J <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3103 �-}�vv <br /> �� <br /> I here6y cedi(y thaf I have read and exemined this applicstion and know Gre samo to he true end <br /> correct. A�l provis/ons allaws and ordinances goveming this type o!�vork�vill be compfefed <br /> whethor speci6ed hcrein or not. The granting of a permit does nof presumo to give authonty to PER�fIT# <br /> violatPo�canccllhop�ovlslonsolanyothersfefeorlocallawregulefingconsfrucfionorfhp � I ^ I I _ O �� <br /> pedortnence olconstruclion. That 1 arn authanzoA by the o�vner of this propedy to perlomi the �j <br /> woik for which epplicsfion is made and!comply�t-!tb tbe Sfate Confraclors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �-r��j �'��'�"j'`e� ll/��/3 <br /> S�pnatwe Da� � <br /> aEv�sen vtara <br />