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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 /> 2605 IS Sr. Fveturrs WA• 95101 <br /> PROJECT ADDRESS <br /> • <br /> * gv.) Aco.at4 iiiiVat4 1W1 Coney AME . srnr, 41$1.1 <br /> • <br /> Owner MyAdowe ply Slaktipp Plmite <br /> SAIA.te As AarvV <br /> Tenant Mall Address City ealalItp Phone <br /> • <br /> AttOttu►2 elu c, Po Woe IfIrs Ktititt,, N a r (44. 1093 trts) $1'1 ioiV <br /> BsJduel Contractor Mali Address city SIM'S* Paws <br /> MObt#WE1 leg t_9 0246 t4 <br /> State Ucense Number(required) • City of Everett Business Ucense Number(required) <br /> APARTsitefirS 416.) 00002. <br /> Proposed Use of Building Contract Price of Work <br /> Tom b 110 (fv ) ' i3ol <br /> Square Footage(If residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> 'A -TV'Sdo to4w►1404a A' UNI.• tam. <br /> Number etdevilu"(If low voltage) <br /> • <br /> Description of Wolk to Be Dons ?hI* t (OF 3) C(went.- 4 errruchicAf N P 44N ov <br /> Li6'4TINIr I ROW. Raft4c A w IAS Q D tMRnria 4- PeP4tlS- OM/ <br /> Pe L-LE9 • QeP.si cir N t+baT1 tJt; w oNE*t` s*TPVL I tilo,rc 0 S1rW 1NL <br /> gEPLACS DIVICAs(4sn CSOOIN e.s) I*s.A.t . <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I hereby certify thatI have read and examined this application and know the same to be true and2.7Z <br /> ,J <br /> Dorno. AN 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 1 r �� <br /> performance of construction. That tam authorized by the owner of this property to periform the I <br /> work for which application Is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ilstii4lomk <br /> REVISED 0&06/1011 <br />