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ELECTfICAL PERMIT APA.ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — L4./ W t-&J-e'1Z-KZ;44 W4 ✓ <br />C; I. .evere44ees & e-veee -f wajdV <br />PROJECT ADDRESS <br />' ��K1 .. t"a t�iyc � �`I� Ebt�� l.-%a � �2•a � . <br />Owner Mall Address City State/Zip Phone <br />Tenant Mail Address <br />City State/Zip Phone <br />t UV Po r oX gip/ fi t"-rf-iv5wa L.�R, `I v�' �3 (y75� 22 Zc�i2 <br />Electrical Contractor Mail Address City State/Zip Phone <br />ICI'-D.Ol-k Lt T- 34� �,I,j <br />State License Number (required) <br />Proposed Use of Budding <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: CCIS"-I <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />07A.LII <br />City of Everett Business License Number (required) <br />2q).cc <br />Contract Price of Work <br />­57 Ci"� XniJ T y&-VVWO„.wgrL�' !'%jvi t-I jV- 4: <br />Contact Person/Contact Number/Email <br />/ 5 AV i !J L /Zr <br />l hereby certify that l 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 <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That l am authorized by the owner of this property to perform the <br />work for which application is made and l comply with the State Contractors Law 16.27 RCW and <br />296.200 WA C. <br />FEEL <br />"fl <br />PERMIT# <br />REVISED 08/0&2014 -a r • G I- - M , r ' / <br />