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10/�8/201a 05:16 14257751960 ACT Nc ENGIniEERING PGG= �1/31 <br />. � <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAxa25-257-8857—www.everetN�a.org <br />7Da L�GJS'I' <br />PROJECT ADDRESS <br />Ownef <br />�+ E✓e��-}I- <br />AdCress <br />Clry <br />SIOtC2ip <br />' /�`9��y <br />E�y�o�o�� <br />Phono <br />\N�.I\�� ����c,�C.�`Cj� <br />Tenant hlall AOdms9 C�.ty Slaie2lp Phono <br />�}�i��G� �n i neeC� (0605 2a0 �'" 5-1- Su1 �-vnn�wdo� w�- `��o3c� <br />ElCctriCdl COnhaCd ail Address Gry SlatolZip Phor•s <br />���; .re-� O�Sgm s <br />State License NumDer (reqwred) City of Everotl Business L�cense Numoer (required) <br />i- \ <br />I eN�� �,nc�S�SCu� � �/� "�dca o P� <br />Praposed Use of Bwltl ng <br />� \l/ <br />SQuare fo:tage pf residential new construction, remodel or aad�lion) <br />�I�o�.00 <br />Contraet Price of Work <br />Centact Person/Contac; Numberl[mail <br />NumUar of devices (If low voltage) <br />Descriptlon of N'ork Io Be Danc, �v � __ �-f�V�l� ��( �r t-u-: "� ' \t�� ��� <br />-�rG:�e/ <br />qTY OF EVERETI� LOGAL SALES TAX CODE IS 3705 <br />I he2by cenUy that I hava rcad nnd examine0 lhis app!icafior� and know fhe same fo be vu�r �nd <br />co.n3c1. All provisions o7laws anJ ordin�nces goveminp fn�y type ol work «iU be comp�Med <br />wbefhei specited herein or noL TAe pranhny of a pemff daee not presume to give vu(lrontyla <br />vioJate or ennce! the prorsiens ol any other sfoM or focol law mgulatlny constructlon or the <br />peAom7onco o�consfroctibn. Thnt 1 Bm aulhonmd Dy f�p o�vnero! this propem� to pedorm the <br />�w�k for which appfica7ion is mado and 1 eomply with f7ie Sfatc ConfracWrs �a�v 18.27 RCW 3nd <br />296.200 WAC. � <br />��� <br />nevrrm er.^r.;n�e <br />FEE <br />�J 0 � <br />PERM1Tq <br />E1�}f0 - 05 <br />