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Nov 5.2015 9:20W No.0764 P. 1 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />32OU CEDAR STREET, EVERETT, WA 98201 <br />.125.257.8810 • FAX 425-267-8867 — www everenwa orc3 <br />PROJECT ADDRESS <br />I�L/IAi�L'�, �-�:`LI_!. i !� �11: l:-� ,!�.� C. r/.� : ��..�T �r,L•: 41 �o .' f, L. (�� <br />Owner Mail Address talY Slate/Lip niwn, <br />1t <br />Tenant Will Addrvk% CRY SlatNhp Pho,ic <br />istt.irL"7 iti.=•ict�,�i_� ,�,t*...�Cf;4, st'1 J.Ul <br />Electrical COnbaUpr Mop Address City S12100p Phone <br />Slate Liconsn Number (required) City of Everett Business License Numbnr (required) <br />Proposod Use of Building <br />Square Footapo (If rostdenlial new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Contract Pdce of Work <br />j.jA it, tJ-A�/ <br />Contact Poison/Conlect NumbedEmad <br />I <br />Description of Wolk to Be Done: 1�1/wl it" t i :� ('.�1-(!_��iJ /i <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby co#1dy that I ham m"and examined Otis application and know Iha samo to be true and <br />cnnorf All provisiars of laws end ordinances gnvoming this type of work will be completed <br />whell ie# specIshad horran ar nnf. rho printing ul a permit does riot proxumr. fo give euthunly lu <br />virNntn fir cancel Use prowslo is of ally other sfofo or local law regulating constsuctiwr or file <br />per/urmance Ncarsfnrrlinn That I am aulhotired by the owns# of this pmprrty to perform die <br />work Inc which appfcabbn Is made and i dompty with the Slate Conlruclors Law 18.27 RCW end <br />290 200 WAG. <br />ftvf. HWWWA14 <br />FEL <br />pF-uMir/• <br />