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02/17/2016 09: 29 4254854320 HILL ELECTRIC PAGE 02/02 • <br /> • <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 /> II <br /> PROJECT ADDRESS <br /> u;A c .4 Pc7k s-k; 1. 0 K <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zlp Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> r <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction,remodel or addition) . Contact Person/Contact Number/Email <br /> Number of devicese If low voltage) <br /> 9 ) <br /> Description of Work to Be Done: flc?ept I L /�4rM,p 5 gs`C e... <br /> • <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 j D D. <br /> I hereby certify that t have road and examined this application and know the same to be true and 11�� L <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 E <br /> work for which application is made and(comply with the State Contractors Law 18.27 RCW end <br /> 296.200 WAC <br /> • <br /> /I1-/2-o(6 <br /> 9n: - Date <br /> REVISED OF/O62019 <br />