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ELEC ICAL PERMIT AP LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857— ta,'Zv u)-e ,t) -id V <br /> e tatii 1 L ve re f-/-.e e5 6 v-�,fe..-ir-t L j d i <br /> PROJECT ADDRESS <br /> • <br /> A ?D 1 I EC�Lc`Tr L-�ya cr (( 'z-z).( <br /> Owner Mail Address City State/Zip Phone <br /> Gi 4Vsl?V E��� G',y►'i> <br /> Tenant Mail Address <br /> City State/Zip Phone <br /> ��pbtuke Le --ric Pt) i30X `I$1-j Vtt't,�i��-�!� L.l '1cbrL3 ( , 5) lz zc, t2. <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> VV.cD.iLe- T 30(6 VI • <br /> I `i <br /> State License Number(required) City of Everett Business License Number(required) <br /> 31 °% <br /> Proposed Use of Building Contract Price of Work <br /> T1l..'v`^J:.a- TSC- .G l�vi li•1i. I�7 t•.i LIN loptA <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: (cYyl-1(1 t-m •-"- <br /> ,^S ) r .�Iul i )ti)S J LI r? jt TS <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 417 1 S <br /> I hereby certify that l have read and examined this application and know the same to be true and J� �f <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 E 6 0 1 141, <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> VAAil <br /> Signature Date <br /> ��U�� <br /> REVISED 08/06/2014 <br />