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02/24/2015 21 :08 #6363 P. 001/002 <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 /> ?.0O Gv G /moo ., - L/i-uPpitk /L.& <br /> PROJECT ADDRESS <br /> PA41'f/a /1107 pG& G/ 01f/' 4/ ,20./ . <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> f"1-'AitiL ..AJ GHQ 5:0,e /, P. Vzs 2,(1pp zed <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 'V Ain / 2LP Cl_6 36 <br /> State License Number(required) City of Everett Business License Number(required) <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 devices(If low voltage) 1—r,� ,� <br /> Description of Work to Be Done: I� I rl v USA ki e 5",r / ! // �/v/t) k I-l 4- <br /> '..2 FEE e,D, <br /> CITY OF EVERETT LOCAL.SALES TAX CODE IS 3105 c. e <br /> I hereby certify that l have read and examined this application and know the same to be true and 5.2_ <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 /> perfonnance of construction. That lam authorized by the owner of this property to perform the E 15,02, - ( "'7 <br /> work for which ap,kaftan is made and I comply with the State Contractors Law 18.27 RCW and d <br /> 296.200 WAC. <br /> .42/Fire Data <br /> • <br /> REW.r,08o62014 <br />