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11/25/2013 23 49 C3625 P 001/001 <br /> � • <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEqAR STREET, EVERETT, WA 98201 <br /> 425257-8610 - FAX425-257-0857•-www.everettwa.org �� � a7-�3 <br /> G�� ��"�� <br /> �6G 1 � /k, l'T�'? vg-l/,� _ �l �-S <br /> PROJECT APDRESS �O� � p�?O/ 2�� <br /> �—�-�'�� �Ul�l}�c.c��kll4t�l'!l ��L -S/�t,1Tf��4-1/ ,�5��'�� <br /> Owner Mail Addmcs Ciry Stata2ip PAone <br /> ►J Cascud�- $(d�,Vl r�i-�.v►a(s — <br /> Tonant Maitnnenas c�ry s��crz�v � Phanc <br /> �'�����-� �,rb�' � P6 ��.x 1 Y�' �c! ���r�G ��9'p9�1 <br /> Eledrical Conirector Mail Addr��sy Ciry SGtr.IZn Phone <br /> �ctJS/ y2� �,, aeo °� _ <br /> State License Number Conhact Pnce o(Work <br /> Propose�ding Contact Parson (PIBn Review) <br /> Square Footage Qt rnsidential new construction, remodal or aaadion) <br /> Nurnber o(tlevices(If low voltage) <br /> Description of Wark to Be Oone� � G Q��,��T��� <br /> fEF �� <br /> CITY OF EVERETT LOCAI SALES TAl(CODE IS 310.5 �� <br /> I�ereby cerLry Ihaf/heve�oad and oramined Ihis app7rcation arW know Gw snmo to 6o Luo and <br /> oormcY. Afl provivnns ollpws nnd oMinnneos povominp fhis typo al work wiH Do rnmplotod — <br /> wAr.fhr.�.yNx:i6od hero� ornol. TAo gr�nlinp ol a pr�muf doas nol prosumo to gin:uuGwrity tu i�M]1�g <br /> violalo orcancu!1lru visia�s ol nny atlwr stafc erkr.nl Inw mgulatinp cnn.stnirlion or tho ^ I� I i _ I a� <br /> pe:Au�muncv ol n�r.tinn. ThaU am aUfho!¢ed by fhe ownerof fhis pmperty�o pe;Aorm tl�r. t 4 � p <br /> woAr for whlcA Gon is made and I canply wifh thn Stnro C;nnfraclnrs Law 18.27 KCW and <br /> 29ti.200 WA <br /> / / <br /> I natu�+ ale -- <br /> �2� �j� .22'�s <br /> tvisco s�au <br />