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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 ‘ 1140e).--0(A <br /> 3—ta-t f <br /> 2736 C-b-10-6 Ave Eve-rett tAIA ?a201 <br /> PROJECT ADDRESS <br /> 1' r6 H;11 C>avrdet Mt) 5ot4 it. 6c le. wA stilt)? 20647t-3roo <br /> Owner Mail Address City State/Zip Phone <br /> r4Or6 14i11 CGtuvat. 2730 Crke6 Ave_ Everett WA Q82o1 206-8f6-35-04. <br /> Tenant Mail Address City State/Zip Phone <br /> /404VA A.C. vi 1.4e- / 37t-45f NWS ,4u6c . tAht RBDDI 25?-0r87-Svrv'1 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> DVANSI—C Z3DP '6o .0c. <br /> State License Number Contract Price of Work <br /> 001061 ere;c. ( JG�son. /44.v"( r' <br /> Proposed Use of Building Contact Person (Plan Review) <br /> N/A <br /> Square Footage(If residential new construction, remodel or addition) <br /> 1 <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: CO f 1 i i 1 kK 4I-sA WAJ( Jl f‘ tom. tta <br /> d <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 500 <br /> I hereby certify that!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 E 402 _ (-)4,5performance of construction. That t 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 /> Ig� Date <br /> REVISED.1/2R/1.1 <br />