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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 /> Z I oz C .6-s 4 <br /> PROJECT ADDRESS <br /> ?ad tern h' rA 21oZ cke5 Avc. mac- # w gzrA <br /> Owner Mail Address City StatelZipA�r 292Phone <br /> -Dig <br /> Tenant Mail Address City State/Zip Phone <br /> Tr n` Fete t Lt_L lsi A-ye 4)ain 1 �k q Si'-4 (deg-Orn <br /> Electrical ClIntractor Mail Address City State/ZipPhone <br /> 1-12..1 "Iei.._q 11 2S ortei z <br /> State License Number(required) City of Everett Business License Number(required) <br /> rel` <br /> Proposed Use o9Building Contract price of Work <br /> jC44-K1 itekze4 <br /> Square Footage(If residential new construction, remodel or addition) Ccct Person/Contact Number/Email <br /> Number of devices(If low voltage) L <br /> Description of Work to Be Done: -1IG( C✓-cb<< Vie] <br /> I Cle1� t V <br /> .Y 1 hG 11-2AAJ CI GL fir{G�C_ <br /> G: c otgi Alc 'i <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 75CP- <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 150S— HZ O S— �� <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 2..1n 51 a2 <br /> � cIS <br /> ig ature Date <br /> REVISED 08/062014 <br />