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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 /> PROJECT ADDRESS <br /> SS5Z2 h <br /> Ave. Sc22 aiatrz . 9.7 2t 47 426 3'45161 <br /> Owner MaiJ Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> lames gobs e- e — li s 6ki6S2 &LScrn 3tgo <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> M6 91-cc--r 601\ 535 H I <br /> Sate License Number(required) City of Everett Business License Number(required) <br /> 41600 <br /> Proposed Use of Building Contract Price of Work <br /> y$‘B.i da6 c' 1y no <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: �VtQ.A- 2A0N1 l?-OV �(2____ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 — OC <br /> 1 hereby certifythat I have read and examined this e 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 • 'local law regulating construction or the <br /> performance of construction. Tha - . authorized by the owner of this property to perform the E 15 03 - I ZO <br /> work for which application is ma•: _•• I comply wi h t, ate Conhactors Law 18.27 RCW and <br /> 298.200 WAC,\ <br /> 1 lr- ' ' <br /> Signatu ` Date 6 `- 3 <br /> REVISED 0a0612014 <br />