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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 S 4 I -14( <br /> -� g�tS <br /> Z73o vhKEs J vt; CvE4Efr, Lim Q12ar <br /> PROJECT ADDRESS <br /> /1/4125 NIL. CF ci/Zal "11! NW sok4 sr SEArra: LA/i4. feta 7 206 -PL- <br /> Owner <br /> lfL Owner Mail Address City State/Zip Phone <br /> Fdv1.1i,47iU,v °weeK 273o oAKES AVE EvEeEri w, 9 '2oI 2C6 4r6-38nt2 <br /> Tenant Mail Address City State/Zip Phone <br /> ADvAAJC.GO 5 r&AJs Lt-� 1 3?t'^ Sr 11/411A) Al. Ao 't eid w 48v01 253.987 -5461 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ADvAN54- 4Z3 OP <br /> State License Number(required) City of Everett Business License Number(required) <br /> Coen 'az/AL /CNvacH ,}�3ov.dCJ <br /> Proposed Use of Building Contract Price of Work <br /> /A- J4'506J iAvwQ 25'3-q 7-5rrog <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: DJ5T4LL *JE !ELVR t s.J4lEO “✓/11-L St GA/ *JP <br /> Ce..u.weer q-, 6:k s r,01 G Pow.E4 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 bO°0 <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 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Ey/5— <br /> gnature Date <br /> REVISED 08/06/2014 <br />