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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 /> 3 �Z. W mac- c 1 e <br /> PROJECT ADDRESS <br /> SOJ tA—Te Ps1/4 <br /> Owner Mail Address City State/Zip Phone <br /> S <br /> Tenant Mail Address City State/Zip Phone <br /> A pk . ez_Ti \L_ , ctg <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> pi O5 SST 1 �? <br /> tate License Number(required) City of Everett Business License Number(required) <br /> � 0 <br /> Qui�,CZ, S P�� ‘ .-- <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) <br /> Description of Work to Be Done: J A 0 1�+ 42-44 riZ Ld £'C o N''S <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that 1 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 /> performanc- : .gstruction. Tha I am authorized by the owner of this property to perform the E 150C-026' <br /> work for ich app ;.tion ' . d and I comply with the State Contractors Law 18.27 RCW and <br /> 296.20r WAC. <br /> 1,5 <br /> Signa ure Date <br /> REVISED 08/062014 <br />