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• <br /> ELECTRICAL PERMIT .P LI C AT N <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 /> 601 5 61/4)4.614 Wey ioheeS <br /> PROJECT ADDRESS <br /> R0V,(AW.6entL ?rOtex4C(ZA ' b 5 .-�.�4-VNa�II: 5�R.,/06 ,3 CS -WA- 616 246 <br /> Owner Mail Address City ate/Zip Phone <br /> 2OI -i o veeS (07 5“-'44-11/1.4.11W364/ 51e6 G87v8 718 i Sso <br /> Tenant Mail Address City State/Zip Phone <br /> \4..k G 13500303 PMBlot24P Mlloreekm -R 12 `35q=t 61(72- <br /> Electrical <br /> 1( 2Electrical Contractor Mail Address City State/Zip Phone <br /> • <br /> k. eLgo o7bs 1 0 X51+3 <br /> State License Number(required) City of Everett Business License Number(required) <br /> eik ZOO fraa <br /> Proposed Us of Building Contract Price of Work <br /> LOCO 1VAVe LjS <br /> SquaFootage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> A <br /> n _ <br /> Description of Work to Be Done: A t• ZQ 411) CAv-CAA <br /> • <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 is° <br /> 05 <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 i f <br /> performance 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 08/06/2014 <br />