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05 27 33 a m 09-IS-2000 212 <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.gov <br />1525 -q':- t S-t . SW -4200 CfT-.JOb-0 \r5D'k 1l <br />PROJECT ADDRESS <br />ComcaJl-Cable" --4-1. A . I <br />Mail Ade,ess <br />city <br />Slate/Lip <br />C- I St)-7 -109 <br />-7-17-Is <br />Phone <br />'ll hWl- <br />CkLiL <br />1525 J5"" <br />1. <br />SW Eyeye+l rWA-1 °I82o�) <br />K_ <br />Tenant <br />Mail Address <br />tub city Slate/Lip <br />Phone <br />Ti-inn Eledhj c, <br />1292R WoY-MW <br />Eel IeyLai WA98.W241D10 <br />Electrical Contractor <br />Mail Address WA <br />( 'J+e city Stale ip <br />v� <br />Phone I' <br />8 <br />eCTITAWEIgLAOg <br />U'_ o51191 <br />Stale License Number (required) <br />City of Everett Business License Number (required) <br />�u,000 <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low <br />Description of Work to Be Done �-a+'7.7lJii — <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 310S <br />Contract Price of Work <br />Irot6she -h-hY%elertylc, .ne <br />I hemby cortify 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 :his type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authonty to <br />violate or cancel the provisions of any other state or local law regulating consfruction or the <br />performance of construct/on. That I am authorized by the owner of this property to podorm the <br />work for which application Is made and I comply with rho State Contractors Law 1, RCW and <br />296.200 WAC. <br />4re Dale <br />mL1 MV C60640I4 <br />f F. E <br />4 <br />PERMIT# <br />E I5(Tl - Io3 <br />