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• <br /> ELEC ICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857— Lai w u1-e t' K4.9. ";" w _ v <br /> ett2(L.; ps <br /> C. <br /> PROJECT ADDRESS <br /> at 13 1 D Vii/ I hl") -2 ��t12�� U 7 Z,J ( <br /> Owner Mail Address City State/Zip Phone <br /> CI24l•iY\l E VU I r`f <br /> 5. <br /> Tenant Mail Address City�(y State/Zip Phone <br /> LAC.- ELZ11-7-- /IL 1/V f302( LI,911 14, ✓ 1/�JJI• I °L.,'V S/ <br /> Electrical Contractor ��- <br /> j Z5� X22-2o 17 <br /> Mall Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> • <br /> Vit► VL: <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage (If residential new construction, remodel or addition) —& l.iN�,tom <br /> Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: CDC f E-TIL7[-)-L .y 5AV i N L <br /> Z.- ' ��(-•Cln'�6T1- Com- LiG;-t TS 2 <br /> • $-1\T1 fir\ ) rua Gl K- ti S C r re e.t t-I 1 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 . /� <br /> I hereby certify that I have read and examined this application and know the same to be true and +� /" v� <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 lam authorized by the owner of this property to perform the E E 671 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature f J Date <br /> REVISED 05/06/2014 ?t L L E-7-1/9 , <br />