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• • <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— w/zv t-(J-e i' v Wet y V <br /> e itko..i 1°. Z.✓g.rQ-}4.e.p 5 g if..1/6-4/644-1 tea- .1 d <br /> J <br /> 2C.- <br /> we-<-t 5'i-- <br /> PROJECT ADDRESS <br /> " A • v o 131'..X ' 17 1 7 E�E-12-8 11— L')i 5 Z°.I <br /> Owner Mail Address <br /> City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> If\AOV LAS EI.CUT1ZI& PO 00 x y 8z <br /> 1 Int tst(--t-va,-,1) 11.)4. 1 (t)° E's (L,z 5) ra z,;)17, <br /> Electrical Contractor Mall Address City State/Zip Phone <br /> Al'-•C;b‘A Lr x 30(6 k.if D'C I1 <br /> State License Number(required) City of Everett Business License Number(required) <br /> • ACO-V;L ,\Iis .4' 25 0 <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage (If residential new construction, remodel or addition) -1-1-C— 64)I J Tsc"-hw9,4tyvr,.ti? iv,....r LiN(c.,(044 <br /> Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: CDSC.n(!c-')& 7 SAV I rr <br /> Itr""t"v,aL�"yvt6"7vi- ci-p_ Li(,rIT-c: I <br /> r'vT11 r"1'1& I 1241:.113l :'L h S 1 Z- c-t r?-c%y / n <br /> • <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Gl° <br /> I hereby certify that l have read and examined this application and know the same to be true and ,5 0 <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 /> pen. <br /> work for which applicatioormance of constructnois made and l comply with the State Contractors a v 18.27 RCW and E <br /> 296.200 WAC. 150-7 That I am authorized by the owner of this property to perform the - IIS <br /> (AX 4)-7oG ii nil <br /> Signature (I Date ` <br /> REVISED 08/06/2014 . t c L !VS-t-f <br />