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Ocl. i2 2014 3:55F��� <br />� <br />No.14�1 ?. 2 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-Sd57 — www everethva.org <br />��oa-� ��; 8� <br />PROJECT ADDRESS <br />�o ��� -iY <br />c �ur��-�uy <br />1-/d � 35.3 <br />�� r�9 E-o � ��-`a,�i e.u� S�- ��.er. � � q Q5'�o 3 1 e`l 5- <br />Owner ldali ntldress Clly Slnle2ip Phone <br />/v � <br />Tenanl Mad �tltlrQ65 Cily SIaIMZ�p PNOne <br />� �^�� �7q� <br />'� � i:>oi.r.c �I�e,�r `.�`a0 re V�4a... 5} oawoc Grfl� 95' 7.� 738"(�i <br />Efet(ncol Contr,7C101 h"2II AtltlMss Clly S�nte2ip Pbone <br />t,�vf'i '1" b'S t`� `l ��'1� 1C <br />State Licenstl Numbr.r (reqmred) ' <br />�. � • y <br />Pioposed Jse of Builtlmp <br />S�;u, re Foolage (If �esiden�ol new construction. rernodol or add�uonj <br />Number ol devices (II low voltage) <br />v� ��g� <br />Ciry ot Eoerctt �usmess License Number (requne�tl) <br />���a a-�°� <br />i <br />Cg�Uact Pnce ol Work <br />(.�kw� �\ g,fd W +1 <br />�n-u� �� c% 4 5 tu.n.�... q��; vin <br />Con1aG Person/ContAr.l NumbeqBnail <br />Oescrrylion of Woik to F3e �one. .L�g � �� .5 •. ✓.q �2 �ti,.�� c� l�� T'�-�^-�� �k •� c. t���t.s�'' <br />CITY OP GVERETT LOCAI SALES TAX COUE IS 9106 <br />I horeGy ceri!ly th�f 1 havc reoJ and nramincAfhis apphcahon ond knuw (he sarne to bo truo antl <br />coRvcr nii ��ov�sions onaws anN aJinancos goveminy (ms lype o/ �wrk will Y.o compfeted <br />whclhr.r 5poal�oAherein o� nof I hc sranlmg ot a perm(( doos nol p�esumc !o yivo au(hnnty to <br />viola(e or cancol fhc provis�ons ol,vey ofher � �ato or local !aw reg�dafurp consfruction or fhc <br />puharnance ol conslrucbon That I am aufhonred by ffre o�e�ner o! rhis proporty fo per/orm tho <br />work lo� �tiduch applic�Iion is rnnde anJ I tanply wilh fhu Stafa Conlrottors Law 78 27 RCW anU <br />298 100 WAC <br />_ ��J.� �.. �k.= I b/' a� a� i< -- <br />siqnal��rc -----� Ualn <br />O[t�5Q00Rb�'IOr1 <br />fE[ <br />5� °� <br />PERMIT# l <br />E I y ( �� -1 �} ----J <br />— -� <br />