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ELEC ICAL PERMIT AP (CATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 FAX 425-257-8857 — t41 t•v t _et';���`?tet wet-i <br /> e ttv,1 ('. L 11 L'e 1 T.e p546,) t/. ;'6,/46wG •- • �J V� <br /> PROJECT ADDRESS <br /> L 1 l A 190 tj a i< 15'1.-7 c1 7-0 <br /> Owner Mail Address <br /> City State/Zip Phone <br /> Gi ii1 h:))'v 6 CW 1'1 121-5. <br /> Tenant Mail Address Cit <br /> � �I City State/Zip Phone <br /> tAZOl/t l ke.. ELZ7C IL I'b 5o X l t Lj ���I �!3 (Ll 7 s-) r;' lZ Zc+ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ;bQ\L-E.- 3t> `i <br /> State License Number(required) City of Everett Business License Number(required) <br /> 'JY f�ii%T1ti+.CIv l J <br /> Proposed Use of Building Contract Price of Work <br /> 1 1 C-rlAS.l/41 IJ -r-ss- 44-KA <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: ��S �t �1L( (-7s'b ,r SHV i N Cr ,6;-i7 S <br /> ` -w-n i< ti's 1-1& ) 14:\i i ( l t t)S I 3 6 1('c-Gtf/7'r- <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /+n "15 <br /> I hereby certify that/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 l am authorized by the owner of this property to perform the E J�IC1 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and `% (J <br /> 296,200 WAC. <br /> )./. <br /> Signature �� ��a� /0203— <br /> J <br /> REVISE008/06/2014 -at'LL T\ <br />