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12I11/2013 06:34 2069575105 BLUE SKY ITI PAGE 02102 <br /> ELECTRI�AL PERMIT APPLICA7'�ON <br /> GITY' O� EVERET�T PERMIT SERVICES <br /> 3200 CEDAR STRE�7, EVERETf,WA 98201 <br /> 425-257-8810 - �AX 425-257-8857'—www.everettwa.gov <br /> 2��� Gc�����Sii�( ,�C?�� ���� G21�}- T <br /> � C���� 10� �-� g �. ��� �' /��um� � <br /> _/� � �- �0 6 <br /> i'ROJECT ADDRESS <br /> ���� �� �� ��� � G� ��1�� <br /> Owner Mail Address City Statel2,p phone <br /> �� ' <br /> 7snai�t Mail Address City State2ip Phone <br /> l�.S�Y j 3315�5 l�'�i v � '���� o <br /> Electrical Contractor Mai!ABdress Ity StatafZip Pnon� <br /> ��U��S�S`.l, `�3�/�-� �1/ � <br /> State License EVumber(required) ty of Everet�Business L csnse Number(required) <br /> �� �%iC�� 7�� � � U~— <br /> ����I / ' r �r�l � __ _ <br /> Proposed Use of Building Contract Price�f Work <br /> ,,.,� ��,o�'� �S� r0� <br /> C�����/����/ <br /> Square Foatage(If resldentfal new eonstructlon,remodel or addition} Contact Person/Contact Number/Email <br /> G�� <br /> Number of devices(If fow voltage) ' <br /> Des�ription of Work to Be Done:�N�� �a���•�(J��f�(�� �(��� <br /> z���� �11���. �����'v���' � �L��(�� C� ���� <br /> ���� .'. � �'� � ��J ����l�-�� I�'�v� � <br /> L� �a���� ���y- � � <br /> FEE <br /> CITY OF Ey�RETT LOCAL SA�ES TAX COl]E I$31 Q5 � ��+�� <br /> , I hereby certify that 1 have read�nd ex��nined thfs application$nd know the same to be true arid <br /> carect. A!!provlsfons oflews end ordfnences governlr+g this type of work irvil�be complefed <br /> whether specified•herein o�noi. The granting of a permit daes nof presume to give aufhority to PERMIT� <br /> vlolafe or cance!fhe provlsto»s of eny oN�er stata or loca!law regulating consfructlon or fhe � ��� D ` <br /> performance of canstructiorr. That l am authcvized by the owner of this property M perfarrr�the �� <br /> work for which ap�lication rs made and 1 comply with the Stafe Contracfors LAw 18.27 RCW s»d <br /> aas.2oo wac. <br /> � �� <br /> Ignatu _ p� . • <br /> Revtsm oea��no�a ' • <br /> • ,• <br />