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Oct 02 15 05:15a Oregon Protective Service 503-759-4800 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 425-257-8857—www.everettwa.gov <br /> E.vexo.:ft Mc i\ UV&.y j Evere.4-, W) ci$?-� <br /> PROJECT ADDR SS <br /> �3 Re�L\#y Tyvit -rmed-+sl tat- l`42 �a e-VeN 4 Ae-N Wl " <br /> '1)4- c Pxicam,_ l obi N --yr o r7 - 03,Acaltr6. �1c, 28 ZSS <br /> Owner Mail Address City , State/Zip Phone <br /> !G4 •/ • 1 gQ°-Zfl_751 <br /> .. `� !I 1. I+I �f t.► .L'1 .' t" <br /> Tenant Mail Address City , State/Zip Phone <br /> Neck6109foire-C-4 JQ �r ,-� C_, 20C MAA.1 i rte,o cZ °-7OL.rrz <br /> Electridal Contractor Mail Address City StatelZip q-1(_ <br /> \A/Ik e o���oc�s �Pz �`� ?�� 51 S <br /> State License Number(required) City of Ever tt Business License Num r(required) <br /> 00 <br /> Bectkc. 1 F`,ncorIce.. .11.11()(X) <br /> Proposed Use of Building Contract Price of Work <br /> Cg 32_ Zee CLA 5 7I-24(c 3Cf,5S <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Z tcLrt0'eeso ri <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: —..+pej >N-... / � , [ k 0 Ailh. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i hereby certify that I have read and examined this application and know the same to be true and t <br /> correct. All provisions of laws and ordinances governing this type of work wilt 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!am authorized by the owner of this property to perform the E15150-"" 00 <br /> • work for, s Oh application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296. 40 W' . <br /> -lure Dale <br /> • <br /> REVISED 0&06/20f4 <br />