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Te4 _ <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 /> Eel ET WA- R8 243 <br /> PROJECT ADDRESS <br /> EL g T U itJ C AO o gr `i <br /> Owner Mali Address City State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> 425' 176—SII,q <br /> T1V �i ►l�C ��05 20D sr wt.iolA1aoE vor %S (c <br /> Electrical Contractor Mali Address City State/Zip Phone <br /> artV0(0.6 02.62.418- <br /> state <br /> Z62y$State License Number(required) City of Everett Business License Number(required) <br /> IgE-MMEL-- It 32,S 60 <br /> Proposed Use of Building Contract Price of Work <br /> MATI4A4 (AJAL,►MAnI 425-2.18-1-W4 <br /> Square Footage(If residential new contruction, remodel or addition) Contact Person/Contact Number/Email <br /> Number ofdevices (If low voltage) <br /> Description of Work to Be Done: 12.L.MOV IM1 lt:X eX IST1/�&_V16}-t( FfXT <br /> FEE --------- <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 °O <br /> I herobrcertify that 1 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 `�'"��O <br /> performance of construction. fhatl em authorized by the ownerof this property to perform theU <br /> work for which application Is made and I comply with the State Contraotors Law 18,27 RCW and <br /> 296.200 WAC. <br /> 5-19- 6 <br /> ;{gnature Date <br /> REVISED 0440/2014 <br /> l <br />