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Mar. 9. 2015 12: 39PM No. 0508 P. 2/2 <br /> ELECTRICAL PERMIT APP�ICATIUN <br /> � C1TY OF EVERETT PERIUIIT SERVICES <br /> 3200 CEDAR STREET, EVERFTT, WA 98201 <br /> 425�257-8810 - FAX 425-257�8857�www.everet[wa.org <br /> �JD- .�r..�.d � �� '7`� �/ . <br /> PROJECT ADDR�SS � <br /> � P� � � . �o � � lr�-G ���� <br /> Ownef Maif Ad ress City S3aEe/Zip Phone <br /> /�, , � `� _ � �� l/ �/ <br /> �'CJ�,�=�—�? <br /> Tenant Mai!AddTess City State/Zip Phone <br /> � l�r� �r �zu��- �-� �� <br /> �I cal Contractor Mail Address Cily � Stat�/2ip Phone <br /> ��s��o l'l5 �=�� � b�va�"�g � <br /> S L[eense Number(required) City of Evereft Business Lleense N�mber(required} <br /> ��"P�`�. �- . <br /> pr� ed Use o��uilding Contract Price of Work <br /> � � �� � . <br /> Square Foot e(If residential new construction,remodel or�ddifion) Rtact pe o /Con ct Number/Em�ll <br /> ��� �xG '� � / � <br /> � l � � �. <br /> �� � <br /> Number oF devi (If low voltage) <br /> �yYc t�� �����—s�- �bl.cd <br /> qescrip{ioh of Work to�e t5ohe: d�'h�lt��� /�Gccf ��uS GC9 p P�� �LQ, k���j W�� �/' <br /> �v��11�d��� LP .�t/J.[. ,� ��i� �L(��7�Cld�� �����L.26'��@.�' n J <br /> r � � � r.�.- c9�p <br /> FEE <br /> CI7Y OK�V�h�TT I�OCA�SAL�S 7AX COp�15 3705 � �� c�� <br /> !hereby certify thaf I have read and exemined this application and know the same to be trus end � <br /> correc[: AI!provisions of laws and ordfnances governing this type of work wi1!be completed <br /> whether specified herein or not. The granfing of a permit does not presume to give authorify to pERMIT# <br /> vlolafe or cancel the pr�vfslpns of�ny otl'ierstste or local l�w regul�finq constrvc��orr pr the � <br /> perforrnance of construc6on. Thet I am author�zed by fhe owner ot'this property to perform the � I�Q 7j— � � <br /> work for which application is made and I comply with the Stafe Contractors Law 9 6.27 RCW and <br /> 296,200 WAC. <br /> (� r ��/� <br /> i <br /> Signature Date <br /> R6VISfD v8/ON`2o14 <br />