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Nov. 4. 2015 7 : 22AM No. 0928 P. 1 <br /> • 410 <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 /> t 40 g CE- 21/.61 4 Nat (elf t.s.-c) <br /> PROJECT ADDRESS <br /> d : l ' � l / //j et// ioi./ <br /> Owner Mail Address City • / State/Zip Phone <br /> 'J7` &e,t&)'Ade) X4- <br /> Tenant ' M.it Address City State/Zip Phone <br /> . _ 1q�? — 1S.cii� ,'Jk/t <br /> Elect ic:I Contractor f Mail Address City State/Zip / 7 L Phone <br /> ./ e K106 61S2O't 1 <br /> Stijl icense Number(required) City of Everett Business License Number(required) <br /> Propose. Use of Building Contract Price of Work <br /> r <br /> Square Footage(If residential new construction,remodel or addition) ontact erson/ ontact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: 144.4 / 45 16-7/t4i9ki.ku&A___-..) <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3465 0 1 c5 ©_C <br /> !hereby certify that!have read and examined this application and know the same to be true end <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 p1 1RMrr# <br /> violate or cancel the provisions of any other state or local law regulating construction or the e �O <br /> performance of construction. That!am authorized by the owner of this property to perform the E Ib <br /> work for which application is made and 1 comply with the State Contractors Law 98.27 RCW and <br /> 296.20 WAC, c <br /> 0 <br /> I1d' <br /> Signature Date <br /> R5VIS 0 08/0512014 <br />