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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.gov <br /> PROJECT ADDRESS <br /> Lae., ls. Po &� Ie -ot'4 se214e wPr q� Of CLo6) 47L3- Zo5 <br /> �a <br /> Owner Mail Address City State/Zip Phone <br /> ki[ter Sunn Cu el24 E vwt44 ' Li1) �S-zy f (4zS) <br /> Tenant Mail Address City State/Zip Phone otirl <br /> Gi -1i4a4M AlaV'wt,Ziac. ZoW 4`n� <,e— ttt: W A- I-M3q G"r) uy-5z15Ff <br /> Electrical&bntractor Mail Address City State/Zip Phone <br /> WA5141-kz z"67c- D Z S Z cf <br /> State License Number(required) City of Everett Business License Number(required) <br /> `� St 4ob <br /> �IvrWleyGt�t t( <br /> Proposed Use of Building Contract Price of Work <br /> sav► tkw� - ctc�� 4365332 <br /> n- 5 0C)C) .cr)"-7 <br /> Squar Footage(If residential new construction, remodel or addition) Contact Person/Contact Nu er/Email <br /> G <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: lileGJ CC,'fiU StprS' vV► ColilSt�bfii�y. <br /> o� 426 u,^ c,7mu7- optr mon' 4 e oe- lVUe, <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i 00 <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 00-5performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ignature Date <br /> REVISED OM62014 <br />