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• <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES tO -4 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.gov /0-dO <br /> Lt <br /> gg50 vter'yreerr ?/11 ,S+e, y (50 <br /> PROJECT ADDRESS <br /> p am 3 Pr p -('!e,a 4 (4-6 9.1 3 0 ...fs.v e. r ce..91 Yir v WA 9 8 O- <br /> Owner Mail Address City State/Zip 425-353 g(ire <br /> au-o ,at, e.o I(e�e o«xrt e °v e .� <br /> Tenant Mail Address City State/Zip Phone <br /> M ke3 itle,01,1 A t9 n s Z2 (& %oaf 5+. 5<a Jive-re*, WA 98Z 08 4z5-s o i g -O0 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> M (Ka5i\CS03a <br /> State License Number(required) City of Everett Business License Number(required) <br /> g��w-t-y 0 ( -Foos 00 <br /> 506 <br /> Proposed Use of Building Contract Price of Work 4z5- ` <br /> J fp <br /> orr1a� $ZO-a�(OO <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> j eff @ crp�61,-04c4.619n , corn <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Iii+cot( o n c �(z a.n n -( 1 ems- .31 g ri i rz Fes"n «-(y 11+ o <br /> face <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 At <br /> ` <br /> 1 hereby certify that I 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 <br /> performance of construction. That 1 am authorized by the owner of this property to perform the E \b 0 0 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.2 Are / / <br /> 1'1111 t IS <br /> Signet - Date <br /> REVISED 08/0. •14 <br />