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• <br /> ELECTRICAL PERMIT ADPL C z,, TLfy'2 ,f <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — to t t)-e wit• eld <br /> tiA1 ;i <br /> e t - I'. tvF v4' <br /> ere- -.e 9S - e-r t zz- • d <br /> i - tit Dt� <br /> PROJECT ADDRESS <br /> • <br /> Pa Ifo% l h�-I ��bL•1L�TJ' I.�N� of � 7J <br /> Owner Mail Address City State/Zip Phone <br /> G^iCvtlUi1'vt tA)TonYnt llYYj. <br /> Mall Address City Stoic/Zip Phone <br /> 1 <br /> 1(1/601.4 El e-L-712-IC. ('b 1 o X "'bit/ Vt 1Z-V—i.uai-,E) �ti`'1 L.� r <br /> iD$s ( ft22• ZoIZ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 30`6 7 <br /> State License Number(required) City of Everett Business License Number(required) <br /> 12)FTIA•0\irS 4. G9 0 <br /> Proposed Use of Building Contract Price of Work <br /> 'TT G'LtS.ititIJ -r AIj..rt t..cii, fV Sl"INt,G,(t Nbl <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> • <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: CDS e11L(C7hi ,'Y 5.< ''v i I-i I!�-t-V:V,-,11ytii tri j- OF= 1.,(,;_+7 <br /> 12IA ) tua Ge S Ici t2 c..,►-c 5 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 5-7 ` 0 <br /> I hereby certify that l 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/am authorized by the owner of this property to perform the El 5j I ll - 0 1 I <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and ll <br /> 296.200 WAC. <br /> Signature a r I. <br /> l <br /> � <br /> REVISED 08/08/2014 311_t- r7) e(-1-74 <br />