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‘i?.1,47Y • <br /> 11\60-1 411,3yra <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 /> 3 L 11,ID 9`t' Ee1 1 W 98201 <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip PhaneJ <br /> Tenant Mali Address City State/Zip Phone <br /> 425-776-e119 <br /> A flV _a16Ip L 5 _2.'0D ST 6v.) L.-MOW-6'6 WPW- q$ ,3b <br /> Electrical Contractor Mail Address City StatefZlp Phone <br /> PiceiIV O 'MS 016 <br /> State License Number(required) City of Everett Business License Number(required) <br /> AP Pr M EAT jEMODEL _—_ t 32S .00 <br /> Proposed Use of Building Contract Price of Work <br /> J Ti-A4 MALT MAA 42S-218- not} <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Emall <br /> Number of devices(If low voltage) ^, � <br /> Description of Work to Be Done: g.Eft` A0` e `4' EXFA STiN <br /> &1_.L 161-1L FIXY. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 , 15. S <br /> I hereby certify that I 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 10�y D�� <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application Is made and I comply with the State Contractors Law 18,27 RCW and -� <br /> 296,200 WAG, <br /> • flf 29%k 5-19- 6 <br /> ---__ <br /> STgnature -Date <br /> REVISED osJe of4 <br />