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NOV/18/2013/1110N 01:53 I'M FPI Seattle FAX No. 4252909600 F. 001/001 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 88201 <br />425-257-8810 - FAX 425-257-8857—www.everettwa.org 11-19-43 <br />Cf.3 11-ro7 <br />PROJECT ADDRESS <br />Zv <br />i <br />k Nta I <br />1,10I.si- <br />Vat* <br />.MAI <br />I WA I r-�>a-e <br />W- ago <br />Owner <br />-E-��—Vnz J&tPgA 1goz <br />Mail Aaorec6 <br />�'E Ey,vz <br />, <br />City <br />}+ Mail—► gy4b93,-ve(*,, <br />_ <br />Stete2ip Phone <br />V-41705 <br />Tonant Mail Address 'iL ly <br />Eif& Ins• P a- , )A 17-b +h�� I �✓� <br />State/Zip Phone <br />4So�Z ku'L9D� <br />Electrical Contractor <br />Mall Adorese <br />City <br />State/Zip Phone <br />ffiltzC--PIV02LN1� <br />StatD License Number <br />Proposed Use of Build <br />Square Pootage (If residential new construction, remodel or addition) <br />3 <br />Number of devices (If low voltage) <br />Doscripbon of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /># �,100-ram <br />Contract Price of Work <br />1/&.IA6 Yl <br />Contact Person (Plan Review) <br />I hereby cerilty that I have read and examined this application and know the some to be true and <br />correct. All provisions of laws and ordinances governing this typo of work will be complotod <br />whotherspccf6od herein or not The granOng of permit does not p ii to glve authority to <br />violate or cancel rho provisions of any other state or local law rogulatibg constriction or the <br />performance of construction. Thai 1 am authorized by the owner of this property to perform the <br />work for which application is made and I comply wi0 the State Contractors Law 18.27 RCW and <br />REvgFaawond <br />FEE <br />�sl ,Sc <br />PERMrrB <br />E 1311� �J <br />