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To: Page 3 of 3 2015-06-25 18:46:50 (GMT) From: Tyson O'Neill <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVER TT PERMIT' EENT <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 FAX 425-257-8857—www.evereftwa,org <br /> PRI JEQT ADDRESS <br /> .201 <br /> 6wrker Mail Address city stateaip Phone <br /> c�2qe)q <br /> Tenant J Mail Address City State/Zip Phone <br /> Ada <br /> 7e17 <br /> W Z3 J406 <br /> Electri4l contractor Mail Address City 7 Slate/Zip Phone 05 35 <br /> AwlicL 176Z/A.11e, 0 5 zi 2 LQ E, <br /> State LY—ense Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square FoVage(If residential new construction,remodel or addition) Contact Person/Contact Number[Email <br /> Number of devices(If low voltage) <br /> Desa.iption of Work to Be Done: e9 &I-0 elt r;r_{a,2/j. <br /> FEE <br /> CITY OF EVERtiTT LGOAL SALES TAX CODE 13 31015 <br /> I hereby certify that i have read and oxaminad this application and know the same to be true and <br /> correct All provisions oflaws and ordinances goveming this type of work wit/be completed <br /> whether specified herein or not The granting of a permit does not presumoto give authority to PERMrt# <br /> violate or cancel the provisions of any other state.or-local law regulating construction or the <br /> pedormancoofconstruotion. That I am auMonzed bythe owner oF this pn>petty to podorm the E 15 02- <br /> work for which application is made and/comply with the Stat©Contractors Law 18.27 RCW and <br /> 296-200 IN <br /> hs— <br /> signsture Date <br /> t <br />