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0111af2614 14: 28 4252078891 QUALIT'�r' ELECTRIC PAGE a2�`02 <br /> ELECTRICAL PEI�MIT APPL�CATION <br /> CITY O� �VERETT PERMIT SERVIC�S <br /> 3200 CEDAR STRE�T, �V�RET7, WA 98201 <br /> 425-257-$$10 - FAX 425-257-8857�www.everettwa.org <br /> f31D <br /> � .S� �� C.&�.�, <br /> PROJECT ADDRESS <br /> �L�dpBY,��t/�Wrt� _ 1�dp ��2K ���, �✓'(Ah O`4 �+� 3�G 37 �Q7 ZT,�70 <br /> a�er Maii Address Ciky Stake/Zlp Phone <br /> / rX'.�l•�r-Q <br /> 7enant Mail Address City State/Zip Phane <br /> ��`i�r� P�.rr.fnar��p,�,�L�a�e,�J � l���it�;�.cR � N�i /�e�v.��,�.¢ 9�D.SZ �f 2.S' 7�7 �'8 � <br /> Electrl alContracior MailAddress City State�zip Phone <br /> Qc�t�-[.�cC�r'iS"TiV - <br /> State License Number Cantrac#Price of Work <br /> --(�lM�+t�Ge:cX � ��.. <br /> Proposed Use of Buifding ��� Contact Person (Plan Rev' w) <br /> Square Footag8(If residential new constPuction,remodel or addition) <br /> Number of d�vic�s(If low voltage) <br /> Description af Work to Be Done: ��� pp�v <br /> � y � - <br /> F�E <br /> CITY OF EVERETT�aCAL SqL�5 7AX COI�E IS 5905 ��1 S(� �� <br /> l3 <br /> !hereby certlfy that 1 nave read and exam;ned this applicstion and know the sa+na to be true and <br /> correcG A!!provlsJons of laws and ordinances govemfng this type of ivork wiN be complete�i <br /> whefher specs�ed herein ornot. The yranting of a perrnll does not presume to give authonty to PERMIT# <br /> vialate or canee!the provisrons of any other state or Iocal raw regulatrng consfruation or the <br /> parformanco of canstruction. Th�t I arn authorized by the ownsr of tfrr's property fo perfom�the � l �� �' �p � <br /> work for•wlTich application is nlade and I Comply with fhe State Confractors taw 18.27 RCW and <br /> 296.200 WAC. <br /> � / <br /> Sigi� ate <br /> � <br /> REVlSED S/ZO/13 — <br />