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• • <br /> ELECTRICAL PERMIT ,:A., PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857— w/w t.1-e ve-v wet-y V <br /> e h&r 1'. .c✓e re..44.e p.5 6' c ve-ve.41 er.„f <br /> CI L! v kx) cr <br /> PROJECT ADDRESS <br /> • <br /> Owner Mall Address City State/Zip Phone <br /> Gf2iA Nq6 E iA% r r j. <br /> Tenant Mail Address <br /> City State/Zip Phone <br /> Mt,Dlit Et,cza'7-I eb X t1-1 lsce-k,a,, <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> lIV-tV% E x 30 u' D2, C I 1 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> • <br /> Square Footage(If residential new construction, remodel or addition) Contact erson/Cont t Number/Email <br /> �v; uNtc.,�,,t� <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Cc,crik GI C�"t� 5 Vi N I ��-:���yL, . <br /> �, � LtG;-trS <br /> $r*T-k Fnr+S ) Rte„i6e- j-tDr,DS Z L-ir w, t fS <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 E�C, <br /> l hereby certify that l 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 the1 C__, <br /> performance of construction. That l am authorized by the owner of this property to perform the E I ()7i 2 I .J <br /> work for which application Is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. 1 <br /> 4AI:1.4 06 <br /> Signature t I t hC <br /> tiJ Date <br /> REVISED 06/06/2014 31.t L „f( fi <br />