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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 /> loot <br /> PROJECT ADDRESS <br /> 1A1 Ntke . 93cyO Z <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> C w►� ;,\\ 6etlylc, S"1 a3 ���ice-, Cue yy.,-4- ' - ,M70-3 yZ5 5s� 3 G <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> hoz 31O LI �-/ 053 '139 <br /> State License Number(required) City of Everett Business License Number(required) <br /> � 3€1' • . <br /> Proposed Use of Building Contract Price of Work <br /> /0 9Z3-v-3 3 .3;6 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) 1 ,, �� <br /> Description of Work to Be Done: ‘...'re &r Pc)k/� 01 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 50 °N' <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 15 0 2 - I (07- <br /> work for •, • h a•.lication is •-de and!comply with the State Contractors Law 18.27 RCW and <br /> 296. �� �C. I <br /> 1 -Z/P-1 <br /> nature e l <br /> .g <br /> REVISED 08/06/2014 <br />