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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 /0` <br /> gi q i o-I )) <br /> 0 t Vav ci 6 oft #Ito erlore4 - ctSZ°3 <br /> PROJECT ADDRESS <br /> LS k1.- 17.LOI call AvQ-ice #3—ZCZ EsdeYecun. gettLi <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> 0WMAI <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building <br /> Contract Price of Work <br /> p <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> • <br /> Description of Work to Be Done: UV`QoI (e j/1 Qd lL <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 5o <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the ( LE( D --17 <br /> work for which a plication is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i�a�aTilfe l/ F_ <br /> Date <br /> REVIS 0 08/06/2014 <br />