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ELECTTCAL PERMIT T A P KATI O N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — uti tv t-r)- t-e-K 61~1)41 y <br /> 6 InA I'. -ev L r&-f e/5 & £ye-ye-1'4 ren.- e i <br /> L ' tEP <br /> PROJECT ADDRESS <br /> • <br /> t 'l A <br /> 'o tj,/ l h t ti i-— L � 7 <br /> Owner Mail Address City State/Zip Phone <br /> GI tiA IJ f1 I(E-1,\) C1-1 P15, <br /> Tenant Mail Address City State/Zip Phone <br /> 1(ti .i;'i) i.a>;^. _t e-Z-7.f?-t(; Pb i362( -it,t'I t to i iar.,D LJ a, `I ?)D �'3 (L//2S) 51,Z• 2c;, I Z <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> 1 +a <br /> G1MK(4 J -r - L1,, .W 4,,k <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: CDS6 -1-1L/ C M:r2 {,`r $'A'v` <br /> s i rziA:i1-6i1"9S C-%It. 6,4Ir5 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> *50,6° <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 <br /> performance of construction. That I am authorized by the owner of this property to perform the E I 15-091 <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 I D to <br /> J <br /> REVISED 08/06/2014 -�/1 — <br /> l� I V C.� ( 4 <br />