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ELEGTRICAL PERMIT APPLI�ATION <br /> CtTY Of EVERETT PERIV(IT SERVECES <br /> 32Qd CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> �7�� � e�� ��� �� <br /> PROJECT ADDRESS <br /> a� 2 ��� <br /> Owner Mail Address City State2ip Phone <br /> f�l..��,�,��t-€��2./�� 2707 G6�'/�'✓�. �/C��ZT" G.�/d-/�ZO l �Zo����4 s�i8 <br /> Tenallt Mail Address City State Z p Phone <br /> � � C , z ICJ'-��7! dOZ 2e�C� •3�G <br /> EI�CtriCdl ConttaCtot Mail Addr City 2ip Phone <br /> J�� {' �-�` �,�� 6Z a�e�°� <br /> State License Number • ntract Price of Wor <br /> C�h��n�✓Gtl� �f-��ce lco •Zc`��34ffG <br /> Proposed Use of Buildi�g Contac (Plan Review) <br /> Square Faotage(If residentiai new consiruction,remodel or additionj <br /> Number o#devices(If low voltage) <br /> Description of Work to 6e Done: <br /> �cS�G� B'�L'G�Y c a� � � c 1-e � <br /> G��,-Ga4-I�3 t�S�a�Ie� ��(�lc�t�-U-c� .G�S �h.Gc�c�'�� �tr� " ] ��E5�1��'rY(! � <br /> �� <br /> �EE <br /> CI'tY OF EVEC2ETT LOCAL SALES TAX CODE IS 3105 C� � ,�--- <br /> l <br /> t hereby cer�ify that!have r�ad and examined this applicafion and know fhe same to be true and <br /> comect. A/i provisions of laws and ordirrances goveming thrs type of work wrill be complefed ---- <br /> whethet speeifred herein or nof. The grantiag af a perrnit does not presur►1e€a give autharify to PERMTT# <br /> viofate or cance/fhe pruvisions of any other state or/oca/!aw regula#ing consiruction ar fhe � ,�O� ��t (O <br /> perforrnance of constr�etion. That I am aufhorized by the o�vner of fhis property to perform the `�� <br /> work for which apptication is made and i compfy with fhe State Gorrfractars Law 18.27 RCW and <br /> 296.2QQ WAC. <br /> 2 7 2a�8 <br /> SignBtu Date <br /> R�VISED 3/20/13 <br />