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Oct 02 15 05:13a Oregon Protective Service 503-759-4800 p.1 <br /> • 0 <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 /> (PO4 4m'l 'i" <br /> 1 W z AQ%.,d A WA 17 " o� <br /> PROJECT ADDRESS <br /> Owner Mail Address City StatelZip Phone <br /> rti� I-'tV►/1Q,�{ccs o �rpo�c�e, c�.t rl�•r � r k off �)c li-5 - Z Z--7S <br /> Tenant Mail Address <br /> ' &')c <br /> city ate/Zip Phone <br /> Drat NA ,-5mi Ca LL-C-- Pb G6y ( �.ur�rw,o��704 Z 57(—Z4L3(�S <br /> Elect i al Contractor Mail Address City State/Zip Phone <br /> WACcB#f PZ q15z) <br /> State License Number(required) City of Eve Business License Number(required) <br /> Proposed Use of Buildilig Contract Price of Work <br /> L­7139's _ Rc►c'�-Vn cy.d5 971-Z�j l.-3 -� <br /> Square Footage(If residential new construction, remodel or addition) Contact PersoniContact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: —Re-6c.""2— <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ,}� I AD <br /> I 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 cr 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 /> performa onstruction. That am authorized by the owner of this property to perform the E <br /> work for hick plication ism de and 1 comply with the State Contractors Law 18.27 RCW and ll�� <br /> 296.20 WAC <br /> SIg Date <br /> REVI SED 0a,W20f 4 <br />