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J u 1. 6. 2015 9 : 56AM No, 0735 P. 1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425--257-8810 - rAX 425-257-8857 www.everettwa.arg <br /> PROJECT ADDRESS,�A� 0,41-- &,It-& . xx <br /> �} <br /> Owner ff Mall Address city State/Zip Phone <br /> 14410-.?- ,.& 9,fv <br /> Tenant Matt Address City State/ZIP Phone <br /> Ela ical Contractor Mail Address city State/Zlp�3 Phone <br /> Sta License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> l90 0 4(:: / (fe-` Lty' <br /> Square F otage(If residential new construction,remodel or addition) tact erso /Contact Number/Email <br /> Number of devices(If low voltage) s <br /> Description of Work to Be Done: C� ® _ o` � k U 1,6 A <br /> FEF <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <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 hereln or not. The greeting 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 C authorized by the owner of this property to perform the C' C S�Q 7 ao3 <br /> work for,which application is made and l comply will?the State Contractors Law 98.27 RCW and <br /> 288.20 WAC. <br /> 01 <br /> ignalure Date <br /> REVISED 08/06/2014 <br />