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AUG/25/2014/MON 03. 39 PM Greenwood Heating FAX No 206 462 6216 P 001/001 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3100 CLUAR STRU I . LVLRL I 1 . WA 98201 <br /> 425-257-8810 - FAX 425-257.8857—www everettwa oro <br /> I U.5 7� th st sV! <br /> PROJECT ADDRESS <br /> (42S ) <br /> Cher-i Kur-5dhnn- 103 7tatfh5i SW Fvc, I-1 1,\'A 5S2o3 23ew11 <br /> Owner Mall Address City slateRlp Phone <br /> 1''� <br /> I l/c _ <br /> Tenant Mall Addrags :V StatetDp Phone <br /> AS ya-I wf:56 rl q t-Ic 325 s. :i+cct , sk sr-r;gLr- wii CIS''11 �a 2� <br /> Electrlcai Contractor Mall AddMas City SloterGp Phone <br /> AS Youyv\l C/7-5 1.1 M 01-6 8G-2- <br /> State LicEnse Nurnber(required) City of Everett Business License Number (required) <br /> 5F- $ 045 <br /> Proposed Use of Building Contract Price of Work <br /> I7�5 <br /> Square FFlootage(If residential new construction, remodel or oddibon) Contact Person/Contact Number/Email <br /> Number 0 dewtces(IT f low voltage) /� <br /> Description of Work to Do Done Acid t t—W C) r a-t i+5 {6,, krCi{ /�u� J <br /> C9 <br /> Frr <br /> CITY OF EVERETl LOCAL SALES TAX CODE IS 3105 50 CC <br /> l hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not The granting of a permit does not presume(ago authority to PERMIT! <br /> violate Or dance/the provisions of any other state or local law regulating construction or the ^ I I I <br /> performance of construction. Teat I am authorized by the owner cf this property to perforin the C <br /> work for which application Is made and I comply with the Slate Connectors Law 19.27 RCW and <br /> 2g6 AC <br /> S/25/14 <br /> / Signature Date <br /> RFYISfid o0e67a11 <br />