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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 /> 31Co E, Se ck S+e <br /> PROJECT ADDRESS <br /> w <br /> n b)6. E. Sok E./ere-4 vel P ci82,3 41-5-5t l- 5357 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> 1` bItneow her 3 I& . 6eeek EVe(6 - W q12453 2G-G01-5357 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> 12e5 icientia. Nt/k <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 /> 1 5rnOke Iht. ,rrr) <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: AAA 6) novo t/w a'"' <br /> V b tth r9 bôcckip -a <br /> new be.rrcrn. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 <br /> performance of construction. That I am authorized by the owner of this property to perform the E '1i 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 /> 'bp 041 <br /> 10 Zip e , ' Date <br /> REVISED 08/06/2014 <br />