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06/06I2013 11:20 2063461980 NETVERSANT SOLUTIONS PAGE 02I03 <br /> ELECTRfCAI� PERMIT APPLICATION <br /> CiTY OF EVEl2ETT PERIV�IT SERV�CES <br /> 32a0�EDAR STREET, EVER�TT, 1NA 982a1 <br /> 425-257-8870 - FAX 42v-257-8857-vvww.ev`ereitwa.org <br /> �,�300 t�J G��o�� `�� — <br /> PROJECT ADDRESS <br /> �� i��► �o ��s��o � �.'v�2E-�-� �J v� �"��� <br /> Owrter Maii Address City stste/zlp Pnone <br /> ��/� �t� ��� ' <br /> Tenant Maif Address City StdteJ2lp � P�n�o��` <br /> ���a '(�Sf�N T �Q�`?�`-� �c�MiA'S �-V� � 1��TbN W� ��C'�``� �-l�fs <br /> EteGtrlCBk Contractaf Mail AdQress . City Sfate2ip Phone <br /> ��'�V�� � � ��V `� oc�C_ � <br /> State�iosnse Number Contract Price af Work <br /> C��t-��ELe��.��. ���� �� ���e--��t�� <br /> Proposed Use of Building Contact Parson (Plan Review) <br /> �J � � �� � S�a = 3� ��( <br /> Square Footage(If residential new construction, remodel or addition) <br /> � � �r -� � �`'r�:� � `�°t��P S � <br /> Number of devices(If!ow valtage) • <br /> Descriptio�of Work to Be Done: 4�`�'"�iPr L11i"`'�iC�a c7� ��`'� '�' �� "��Dri'"� i� ��ZXJ�'S <br /> t� �'t�"�'c t�C�t �Q - � � � � �C-t��C�� � � <br /> �h'� � �i�E" <br /> . <br /> �� <br /> CITY OF EVERE'i'T LOC/LL SALES TAX COD��S 3'f05 � � <br /> f�r e�fy t�eE`i lrave r�d r�nd exemit7ed tfd$�qpphiGefiion e�r'!la'►ow the s�►�e in b�t►�e a�nci / <br /> cort�rx ,�1!prr�s cf lsau�s arrr�oxa�r�ces g�rn,ing�is type of wortc+��c�p�et�sd <br /> ►�r��8c�rrs�irt or r�ot. rho grerrtlr�g of a pe�,�;r aoss nor pnes�rrio t+�gi�aurlfor�y ro PeRMm# <br /> uiolate or car►c�/!he p+�v�of any ather s[�fe.or lacal faw tt�qulsti�g[ao+asfiucf'eon c'�r the <br /> perFon�ce of consfitrr� 77�rat 1 am a�fo�fzeaF by�e o++rr�r of this ptapert�r to perfvm�f�he E � �a�p ""Q� <br /> txwik for wf�eic7f�p��t ls►.7'�d!e a�►d I�ly�roidh the SNd�e Cmrtrac."'(�vra Law 98.27 RCW a�rd <br /> � 296 i^00 WqC_ ' <br /> _ l . . <br /> �e Date <br /> REVlSED�2CY73 <br />