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Feb. 4. 2016 10 : 48AM No. 1873 P. 2 <br /> • <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> PROJECT ADDRESS t p r { . t _ 3 <br /> (: 1:7±2 1.:4 l y t �' iLd�;fl:� b-tir` v`'� 4i=C �, �,lk l d�•`� �!1 �.1 �`2 . <br /> Owner Mail Address City Stato/Lip Phone <br /> [.t <br /> Vt <br /> I enant Mail Address City State/Zip Phone <br /> lc. <br /> • <br /> 4 : ` <br /> jl vkJeCVU) ,v. ,� iLC' <br /> Electrical Contractor' Mall Address City State/Zip Phone <br /> State License Number(required) City of Everett Business cense Nurse!(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential now construction,remodel or addition) Contact Porson/Contact Number/Ercall <br /> Number of devices(if low voltage) <br /> Description of Work to Be Done: 7I - ('�' + :f‘ttjt c(01(4_ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 #t <br /> I hereby certify that I have mad and examined this application and know the some to ho true and 415 <br /> correct. All provisions of laws and ordinances governing this type of work will be completed --- <br /> whether specified heroin or not. The granting of a permit does not presume to give authority to PERM IT# <br /> violate or cancel the provisions of any other stato or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E \ ;u2,-62_.(G <br /> � <br /> work for which application is made and I comply with tho State Contractors Levi 18.27 RCW and <br /> 298.200 WAC. <br /> S ure :- Dae <br /> Rev,st!oi6064Or6 <br />