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Sep 2515 08:52a Boyer Electric Co 2063674575 p.1 <br /> • • <br /> ELECTRICAL PERMIT APPLICATION <br /> E I <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 /> g(6 <br /> 141/232_7 te(lak)\ \I\ A), 6 IF? <br /> PROJECT ADDRESS <br /> Aeor.ritzCLQ. rch (Y li i l 5 'ate'3337 <br /> Whet Mail!Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electri ontractor MailiAddress City State/zip Phone <br /> GL <br /> 022c 140 <br /> State License Number(required) City verett Business License Number(required) <br /> • 5 ) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> wine <br /> Description of Work to Be Done: <br /> \I sT c3L-Or\c3/4- *yr-QT., <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 °° <br /> 1 hereby certify that!have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and oniinances 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��� (� i <br /> performance of construction. That I am.authorized by the owner of this property to perform theE 7v1 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> • <br /> 'dill% t_AM* at Its S r Vs" <br /> •igna re Date <br /> REVISED 0aMa2014 <br />