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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 /> ci 7)O4 Ave. I.tL gu _f,eft 9' Dif <br /> PROJECT ADDRESS <br /> N�,atn +�cL qg�'` e W a)erd_ f Ge,A cr2.2O it <br /> Owner Mail Address City State/ZipPhone <br /> 42-5 <br /> — 731-9`156, <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work <br /> t�E1 Milk <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Number of devices(If low voltage) <br /> � <br /> Description of Work to Be Done: CIri (cJ t,�, iec ,-& h tf, tit 'u1 ITEM. <br /> (IAA deck. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> g-006 <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 r�� — DOS <br /> performance of construction. That I am authorized by the owner of this property to perform the E 1 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> \--)vajj\A C C) I <br /> Signature Date <br /> REVISED 3/20/13 I <br />