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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 /> 3 c 5 etxs- Acdt tAi°a , <br /> PROJECT ADDRESS <br /> EVec c LLC 12-U( Ve ck rc glvJ. s-ELIt.dct . C4 Ctldo4 <br /> Owner Mail Address City State/Zip Phone <br /> Retk. �� ‘3b5-- Eu-ksr.l4 I'UCJI( wtlY Eves 4 w ct Inc g <br /> Tenant Mail Address City State/Zip Phone <br /> NAcx>,""t'\A `1W 360-r{2 V-13 23-- <br /> N\- r-Stt-i- 's•A 26pa 41sc-k to 9)&03 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> l\)\-e-(-e5-5 2C R <br /> State License Number(required) City of Everett Business License Number(required) <br /> Ze5r _� <br /> Proposed Use of Building Contract Price <br /> �oof�Work 360_tizY-13zs- <br /> k ,��I L �ok 6,11 e -e`ter-s( 1.cn� <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email U <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Tepfac�. ('1 -""'-` 5 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I='�1 OD <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 �� ��J <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 /> Signature Date <br /> REVISED 08/06/2014 <br />