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Ap r. 29. 2015 11 : 57AM No. 0593 P. 1 <br /> ELE�TRICAL P�RMI1` APPLlCATION <br /> GITY O� �'VERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EV�RETT, WA 98201 . <br /> 425-257-B610 - FAX 425-257-6857—www.everettwa,org <br /> � �"` �`'J�� <br /> �d?�. f�l�, a ,� �!l �_ - -�� <br /> PROJECT ADbRESS H--��'' <br /> _ /�� ',r-�.�--- � <br /> OwRer Mafl dreas Clty State/Zlp Phone <br /> Tenant � Mail Adtlress CiCy 5late��fp pnone <br /> � � l � �� �, �' <br /> EI c ical CorltraCto� Mall Address �ty Slatel7,p��?�G,�� ,hone <br /> �C3.7 <br /> ����S t Ucense Number(required) '\ City of verett Businsss�License Number(required) <br /> � �� <br /> ,� <br /> proposed Use Buiiding Gontract F�rice of Work <br /> �� <br /> Square Fooiage(If resldenti I�construction,�temodel o dditio ContaGt Pef onta NUmbef/�mail <br /> �\ ��� 7��s 70� �� <br /> � \� � �j�/ �!1�@� ��L��1 <br /> Numbe�of devices{!f low voltage) \ <br /> \, �� <br /> Description oF Work to Be Done: Q� <br /> �c � �/ <br /> a � <br /> :�m i� �1� h�,����� FE� <br /> ���. �.° <br /> GI7Y OF EVEI��TT LOCAI.vALE3 TAX CODE IS 5705 <br /> l he►eby certify th&f 1 hsve rsad and examfned this appl�cafion and know the sairre to be true and <br /> corr�ecf. Afl provrsronsof laws snd orrlrnances goveming thls type of work will be completed <br /> whefher specifred hereln or not• The grmrrting of a psrrr+ft does not presume to g;ve aufirorify to PERMIT� <br /> violate ar cancel t�,e provisiorrs of any other sfate orlocal!aw regulaling constructlon or the � � � p! 1� ��� <br /> perfnrm�nce of construCtion. Thaf 1 am authorized by fhe�wner ot this property ta perform the � <br /> work for which�pplfc&llon ls made� comply wifh ths Stste Contractors�aw 78.2y RCW and <br /> 298.20 AG. <br /> vI[r S . <br /> Signe�ure Dal � <br /> Revrs�A o9�os�2o�a <br />