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APR-10-2015 10:40 FROM-AC ELECTRIC 2538135817 T-404 P.001/001 F-415 <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 /> c� VJ . C'.�a st-4o12.8. , Evert,'th <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> -Fours.. Act Pv -s. \DO W .0.0-Mna \I\P <br /> Tenant Mail A ress City State/Zip Prone <br /> lart ls�r- Yt - j�Q $4\N 1�2 or S� S�� c2— Y \ \NSC <br /> Electrical Contractor Mail Address City State/Zip Prone <br /> v1 <br /> State License Number(required) 1 C1 � <br /> City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> � \ /€2-.V3-S52.-O2t <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact NumbNE ail <br /> e-\R YY` a-.Com <br /> Number of devices(If low voltage) <br /> Description of Wonc to Be Done: \Y\''0. 1 \rite-v ov- l -Q c -e*-i ow- <br /> c. <br /> iAri <br /> - re_S� <br /> ♦..Ba\r dt - i\-11 at- <br /> FEE <br /> CITY OF EVERETT LOCAL.SALES TAX CODE IS 3105 111o`''% <br /> I hereby certify that l 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 E1 D(a0 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. / <br /> Slgnac Dae <br /> visgo aaowai. <br />