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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY F EVERETT P E IT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.gov <br /> bib-1S <br /> PROJECT ADDRESS <br /> O lc)o. e e c19r 3 CS Cv P ew.c y. Ey F(-e WA 462 ' <br /> Oinmer Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> t §;c ,, LLC .P.O, i3t>x a.",' eCuA (3 44 -0(04\ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ed C <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> isd bo)-4-64-004t <br /> tAiycid+ tr.)y0J..J-4-E')ec4 r <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Nirmber of devices(If low voltage) <br /> Description of Work to Be Done: ! e (:) IC <br /> C'/CC's 1''10 a c (),--ti 4 s. t <br /> I V1 5' c l l E�e w Clew,cl u i`T t }S C en"✓l('C'? `S 4-0 / C..J r e LTJ 'go o'C#p V)/l <br /> e�y <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105N)Lit •/# <br /> Thereby 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 Ei D r_® OM <br /> of construction. That 1 am authorized by the owner of this property to perform the I l(d <br /> work for which application is made and t comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 6/i /i 5 <br /> Signature 1' Date <br /> REVISED OS/0612014 <br />