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• <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 /> elOR Ewe retf 1401 t.Jcx y 51.0-e t)LN0 <br /> eve re A We'S <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> I�ceuxvnCo %l E' 11 SII pay Sui'4e Fveof fgag 36o-.3z-Ca3' o <br /> Tenant Mail Address City State/Zip Phone <br /> 1 PUr s )--um bec avid fie&c :2 'J 'Robed-Qu,h Dcide ' 1'‘,► 93581e .V5--650 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 600 _Ic ( 5-g 7 t eyd ce ss <br /> State License Number(required) City of Everett Business License Number(required) <br /> Oa/000 <br /> Proposed Use of Building Contract Price of Work (3(o)388-O& ) <br /> LOiet.cri Jl'Iecr n s d,c/cwuc a bfk bleOffiij. <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email c'oK1 <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Tv.644 I letik K of oeu) b retwe ry e jt i p fie' n t. <br /> cetocat,`oma vF 1►3V+ Swe'*Les cold 1,'14 ft'�4 t (t.LAct vufleft <br /> FEE /J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 7^ O_ <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 E (50 3 --( '� <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and r �/ <br /> 296.200 WAC. <br /> 3 iztr 113'- <br /> Sign. Date <br /> REVISED 08/06/2014 <br />