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O <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 /> X 530 EVec1cee W6 <br /> PROJECT ADDRESS <br /> (fi N I\.u\,, l r tskv a,P i20 &)(3 55t1,1 -Tv (-)zu O V ) .11-M3 <br /> 3 <br /> Owner Mail Address City State/Zip Phone <br /> Cna5e, .5itnY `6531) P 4i &cci W� )-eta k LJJ,Pc q C <br /> Tenant Mail Address Q j City Q State/Zip Phone <br /> .. / 41,r/ .► • wL -(q 5. MDual VU(( } Ujdl "t at3 31.10-142-4-13 <br /> Elect'cal Co rector Mail Address City State/Zip Phone <br /> M� P (btaC,t 1 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Corn► La.t ,�� 50O.00 <br /> Proposed Use of Building Contract Price of Work <br /> S r € 1 ndqu►sf <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Cont c Number/Email <br /> 1'1-14-132-c Skt--OrWeer lVti si gn.tort <br /> 2- <br /> Number <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: f t AO -e u1 riTl✓\q S I T O S 4- CTS Z i t) ' a <br /> i llumIc\c�A-r�d C\a n►ui Laity wail! Signs. l <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 450,6S <br /> I hereby certify that/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 i�� ` `-� <br /> U <br /> performance of construction. That I am authorized by the owner of this property to perform the E I <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> VAI-Y 4:611111 <br /> ignatur- Date <br /> REVISED 08/06/2014 <br />