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�4i18/2013 08:12 1425775196� ACTIVE ENGINEERING PAGE 01/O1 <br />Ef��CTRICAL P�RMIT APPLICATION <br />CITY OF EVERETt' PERMIT SERVICES <br />3200 CEDAR STCEET, EVERETT, WA 98201 <br />425-257-8810 - FAX 4Z5�257�857 —www.ev�cettwa.or� <br />C4 . ►. � �.. �� � <br />.,,. <br />Ovme� <br />hfail <br />City <br />C�_�g—/3 <br />L � 3 p C(-1 Z� <br />SIBIMZo PMne <br />S�tm <br />Tenont n�o�t nderess c�iy steic�z�P r-no�a <br />�,yj' —+��;�pe�n� �ofod�5 2nn�, �'tsw ��rv,e►,ds' wp 98o3ca `f2s.�71o.811� <br />C-lett ulConhact � tdoilAtldress City Slate2ip Ptwne <br />hciive�' OBSms I :5Q• (x� <br />State Llcensa Numbar Contrett Prtce oi Wark I <br />Proposee Use of Bullaing <br />Squore Footage (It rosltlentiol new construdion, remodel or addltion) <br />Nurtlber o(devlces (if Ic++volinge) <br />Contoct person (Plen Roview) <br />iDescrlpllonofWorktoBe�one: L�ISCO��f1Pf"r` C���O V`P_f4Ylt'IC['�' Y1QuJ'Fi,�YY'1Q[�- <br />I <br />cITY OF EVERE7T �OCAL SALES TAX CODE IS 3105 <br />! 1 hereOY cerD�y Nat I haw ree[f erM axeiMned CMe eppNcatlon arM Imow ffw sorn� t0 De G'tie end <br />cortv,rL An provlabns a'/9ws and otdMeno08 govem/np lh{8 �p9 d�vork wW bo Completed <br />whotner epedftel heroM or rrot. The granflrg ofa Aamdt doae not piesume to glvp euthoAry to <br />vlolato or carK.rol tfw pioviafonQ o! any dhar etete wlocel lew iegWeMD ccnsfnicctbn a[ho <br />perfamance of ca�sWcypr� 7'het f am atRtiorrrnd by the owneraf fl,ls prt�perry to pe+fbrm Mo <br />iwork fbr whlch app.7ceUon !s rtrods Md ! cvmply w7M the Stete Cwrtndwa tew 78.27 RCY/entJ <br />286.200 WAC. <br />Rf, wbE01?a'l7 <br />FEE <br />50•00 <br />PERMIT# <br />E ( ��-�1--iz� <br />