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a�e: 2 of 2 10/11/2019 11 : 44 AM 'P0: 14252578857 FROM : Donna Barner PH <br /> [ N2064915506 <br /> �----- _.__ — � _ —� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> l�"'�j���7 <br /> i C=/4/O--��� <br /> � 131G Y:�rk Dr <br /> PROJECT ADDRESS <br /> , � <br /> I ,l'usan UaN�son 1316 1'ark Ur F.�•erctt, �V:� 98203 425-355-9443 <br /> ' Ownur �dail ACtlress Gry SlatelZip Phone <br /> I� Tenant �AailAaaress <br /> �'�Y State2�p Phone <br /> � :111PI?U I?Icch�ic P.O. Bo� b68 Evcrctt, �VA 98206 425-583-6414 <br /> ElectnCal Coniractor Atall AOdre,s City Sla'dLp phonc <br /> A;11Pr:1) .�1907n1 _ U�ltt712 <br /> ISlate L�crnse Numbor(requirad) City of Everett 8usines5 License Number(reqwred) <br /> Singlc F:unih� Residencc <br /> Proposed Use ol Duilding ContraCl PnCe ol Work <br /> ISusan llawsmi / 425-3��-9443 <br /> Spuare Footage(I(resiAen6al nmv tonslruclion, remoJol or addi[ion) Cnntact Pr.rson'Contacl NumborlEmail <br /> Numbm o1 doviCes Qt low vOltage) <br /> Description of\NorA to�e Oune: Inctall ri[Cliitc fnr rhictlrcZhi,at n�n�nc <br /> IF[[ <br /> ICITY OF EVER[TT LOCAI SALES TN(CODE IS 5105 ��� <br /> I hereGy c�Rily thaf I have raad and examined fhls applicafion and kno�v fhe same!o be frue and ' <br /> conocl. A/l prowsions ol lows and ortiinances govom�nr�llrrs lype ol wo�k wdl be complofod <br /> i�•hulhor spoaficd lrcrcin or not. Thu qianling ol d permlt does nol presume lo grvo authorit}�to pERMIT# <br /> v�Mafe o�cuncel fho pruvisions of any otfrer sf�te or lucal law repulating Cpns(Nchon or the ((��+"" <br /> perlonn.incJ ol constqicfwn That/arn nulhonted by fhr�mvner o!this propertylo perform(ho E I � I D _ O�/_ <br /> work!or HhiU�applma6on�s made and 1 comp/y wrth the Sfafe CoMracfors La�v 18.27 RCW and � ��J <br /> 29f 200 IVAC. <br /> �� 1 1 <br /> , <br /> / .�Z_�..,�_�.�� �L�• � �t,_ , �� <br /> — si iawre ua�e - <br /> HEZVSEUC89Y.`0u <br />