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Boyer Electric Co 43674575 p.1 <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 /> • '9\ !Lk- -1ALIerC.- • • , <br /> • <br /> PROJECT ADDRESS i <br /> q-cc., `"TL`s et-I E- Vr_fcm\t.c,6 °6133 ..4g,-5-_2 ,.-c <br /> Owner Mail ddress City State/Zip Phone <br /> O'. 41,7 1 W0/1 \ ��C.(c� �C_.ti t 4-`512 `1-S-�' <br /> Tenant i Address City State/Zip Phone <br /> Electri•'j ontractor Mail Address City State/Zip Phone <br /> - ` -EC-lc. 11-- O-7 40 <br /> State License Number(required) City of Everett Business License Number(required) <br /> 1. <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction,remodel or addition) Contact Person/Contact Nu r/E • , <br /> Number of devices(If low voltage) , <br /> Description of Work to Be Done: S t\7 "�'V_ : x- 1d ) 2-2)NIT aCZET-A <br /> rYDL-LL. arNIO 12:1 IPtine P-Z)VoVC" 6V,A1 CCis_4 -. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 0 - -30 <br /> I hereby certify that I have r d and examined this application and know the same to be true and ' l <br /> correct. All provisions of lain end 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 <br /> performance of construction. That I am authorized by the owner of this property to perform the E 16-10 1 - 1 3 3 <br /> work for whi • .pplication is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WA . <br /> 1611.11P7 L .-.( \' --)-—----- k -21'ef • <br /> nature Date <br /> REVISE.0810620.14 <br />