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ELEC1tICAL PERMIT LIGATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — 4.4)4.- V <br /> eh.,s. ( vr>; f.eOs & 6ver' rt,�e� 7 <br /> PROJECT ADDRESS <br /> Pa ijz,jc l 5,y? E�i l2�T� L > 7 zo <br /> Owner Mail Address City State/Zip Phone <br /> Gl wt t`:11.).\)i <br /> Tenant Mail Address City State/Zip Phone <br /> tAe,_ EI6- CL) f,), � i l°—f�i��s��� �% G) S S ., <br /> SV ( : z5) 2,z- IZ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 30` <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> T S C'-tiu3,,vn t•J S e - LINv t6'14/1 <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: Ces `=T7L.1 (&7-2EZA'y $"A'J i N 'bre c.:,�Cytit6Tj_ ,(,;-l1 <br /> • v\'T1-i F+\r Z c,-f tZ r rz} <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � 00 <br /> D <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 l am authorized by the owner of this property to perform the E f rig <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and 11� <br /> 296.200 WAC. <br /> iftliA),A4?7 DG I 5 <br /> Signature I Date <br /> REVISED 08/06/2014 `3 t•C L �\ <br /> r✓ IV 1v-Orv1Jiti tji,1 -2•l i,-+l ! Chi u4,, <br />