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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 /> `)I33 �9T14 ST <br /> PROJECT ADDRESS <br /> fbcA(,KSLoS w I tnES <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> SuMMtLT ELECINC I tiL 6t 33 '1,61'ST ST I\)1,J ' -11\Ahki cob WA SVI-917-- <br /> Electrical Contractor Mail Address City State/ZipLin Phone <br /> Sv pnM SEI dot. (CL- 05 3 'Z- 3 Co 155)S5 <br /> State License Number(required) City of Everett Business License Number(required) <br /> SFY- Sao <br /> Proposed Use of Building Contract Price of Work <br /> 11 00 LEC L(1.5 3( 6 Si 5c) <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) pp <br /> Description of Work to Be Done: Aj&IJ f". CJ t -i!J Cr w«N .L V Pt Jf\P SERA) <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 460It12-.. <br /> I hereby certify that 1 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 ���/� n <br /> performance of construction. That I am authorized by the owner of this property to perform theE " l G� <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> .117Al2-01 <br /> Date <br /> REVISED 06/06/2014 <br />