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From: 1011112015 13:51 #116 P.002/002 <br /> 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.gov <br /> 1 ,•lbOkrVi.)(11 'CAVA- <br /> PROJECT ADDRESS <br /> �� <br /> Owner � w <br /> � \'s �. v-�\a,f' 1,0 �c1,)C W1 <br /> t� ��5 � j <br /> -�^ Mail Address City State/Zip Phone <br /> P <br /> Tenant Mail Address City State/Zip Phone <br /> `,\N R ,c_ k_CiViVAVD lh .3rd <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required)r} <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Pe on/Cdntact Number/Email <br /> moo .. <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: m, X <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105400(5- <br /> 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 Ef <br /> work•for which application is.made and I comply with the State Contractors Law 18.27 RCW and C / I �� <br /> 296.200 WAC. �...,: <br /> Date <br /> REVISED 00/0612014 <br />