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Jul 14 2015 8: 25RM West Seattle Furnace 206 935-0735 p . 5 <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.org <br /> (p [ I ) ems Of se <br /> PROJECT ADDRESS <br /> i' Iti <br /> 51.pq 57g Ca-113 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> wvri.L-n L -k rvi q 01 i'61/41-111' "Pk- Zea- .-1,1-c. c - q 'e! koe z oto e v <br /> Electrical Contractor Mail Address City r� State/Zip Phone <br /> -V\ <br /> t , - L q g D) 00 tag S <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> c9 LA IA <br /> Square Footage (If residential new construction,remodel or addition) Contact Person/Con ct Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: \\C\LAik-\' � QI <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 L <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. Alf 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 E 1 l�}�� f i+ U <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and t� I <br /> • .200 WAC. ( ,, <br /> Lt�r41&.� --'�- (0 <br /> Signature •. e <br /> REV,'SED 0&1m6?014 <br />