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Aug. 10. 2015 9 : 35AM No. 0786 P. 1 <br /> . • - • , , <br /> • ELECTRICAL PERMIT APPLiCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425257-8857 w www.everettwa.org <br /> sThe p,1,4,,,___ 71/-c4-€:-/-- )/(ii-4-7- <br /> PROJECT ADDRESS <br /> Owner Mall Address City State/Zip Phone <br /> l At, ,L _/_ qi(7.- ___ L- ..A. �.�/: ��, <br /> Tenant Mall Address City / State/Zip Phone <br /> E ec ical Contractor f Mail Address City State/Zip Phone <br /> Sta3 License Number(required) City of Everett Business License Number(required) <br /> L-V t 04124_a.c c� ' Jl (� t 3 . -- <br /> ' <br /> Proposed Use of BuildingContract Price of Work • <br /> a5tD .U/ (241-1167- <br /> Square Footage(If residential new construction,remodel or addition) C act erso /Contact Number/Email <br /> 3.) _ 6 . 0/31 <br /> w �(- ems_ <br /> Number of devices(if low voltage) `J <br /> Description of Work to Be Done: tf -e--L_ . .2 ,1k— Qlij ��� • <br /> ( -e---/——-7 4 6 2 <br /> kill IF ' <br /> DEE <br /> CITY of EVERETT LOCAL SALES TAX CODE IS 3106 It I , <br /> /hereby certify that t have read and examined this application and know the same to be true and I <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 �� �j <br /> performance of construction. That t am authorized by the owner of this property to perform the ` b,� <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 288.200 WAC. <br /> 1 •-_ :. / _/ / / <br /> Stgna„le Date r <br /> REVISED 08/08/2019 -t.e...:-L...i_e_— 06v -e-- <br />