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04/08/2015 21:59 2535723628 ROBBLEE'S TOTAL SEC. PAGE 01/01 <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 /> 2.2161 Gil . a - ' ' <br /> PROJECT ADDRESS <br /> A 22og id. craw* ir) ewer} 4yzot <br /> -"� <br /> Owner Mail AddreRs City State/Zip Phone <br /> "'IVA C. — -- <br /> Tenant Mail Address City State/Zip Phone <br /> • <br /> ReAlt s 14m- $mog( 7stfientrw IL $ *ay* w' ' U'Ib4 *'sinr <br /> Electrical Contractor Mail Address <br /> City State/Zip Phone <br /> RobbL1-5 494 Ft, 04 io512of1 ' gebtess <br /> State License Number(required) City of Everett Business License Number(required) <br /> 7'coo <br /> Proposed Use of Building Contract Price of Work <br /> in 1-14.6 r z.bl. - 311- 5(.13 <br /> Square Footage(If residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done! V-tiNa Vbt. C %Wa t <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Alf so o4 <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 1 6152 <br /> 7 <br /> work for which application is made and i comply with the State Contractors Law 18.27 RCW and <br /> 298.200 <br /> S gnatore 4 Date <br /> 444 t�, $ r V''Ce i r'e�+M,, eGS . cam <br /> REvf550 08/082014 M� �---- <br />