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_. _ <br /> Tzeill • kre.,0-1 • reevi. _ .. . . . .. <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 /> _ `�(` L-► 4D EA $Y` ENI 1 WA- 9$2.01 <br /> , PROJECT ADDRESS <br /> i ^ <br /> R _Joh 14�j2 Lt i 6 �"i 071-tOgrThl --- — — <br /> Owner Mali Address City StatafZlp Phone <br /> Tenant Mall Address City State2ip Phone <br /> 1-125'7 -8►I.9 <br /> CT1V iI iI�C� (0 5 D ST ?__l-`i►JrJt�Jio .w $- 36 <br /> Electrical Contractor Mall Address City State2ip Phone <br /> pcT(ve*- $t pAs 0262.e{$ _ <br /> State License Number(required) City of Everett Business License Number(required) <br /> _ R .-r 4 328.00 <br /> Proposed Use of Building Contract•Price of Work <br /> NA ii-lAt3 WAIL M1 4425-218- 1704 <br /> Square Footage(If residential new constrtictlon, remodel or addition) Contact Person/Contact Number/Emall <br /> t4/A <br /> Number o devices(If low voltage) ,, A�^^``'' 'Rt <br /> G /� // r <br /> Description of Work to Be Done: gEpko y- 'RtP ex I ST)N. I_1A141 FIXT <br /> i <br /> 1 FEE — — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 1 6.6D <br /> I hereby certify thatI have read and e amined 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 taw regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E61/606" C 13 <br /> work for which application Is made and I comply with the Stato Contractors Law 18.27 RCW and <br /> 286.200 WAC. <br /> (--jj-DIM..6k..CA,`"-- 5'19.- (5 _ __...._. <br /> Signature Data <br /> Re SED 031;614)14 J <br />