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Jan. 22 . 2015 09 : 08 AM PAGE. 1/ 1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-2578857—www.everettwa.org <br /> PROJECT ADDRESS <br /> Owner Mail Address City Stateop Phone <br /> Tenant Mall Address City State/Zip Phone <br /> C-TRI C- dV &tZ-A i5 -AhQrg e.e� UN, J$ -� <br /> Electrical Contractor Mail Address city State/Zlp0 S,3 7-Phone <br /> AJ 6 q f2 05 <br /> State License Number(required) City of Evereft Buni vas License Number(required) <br /> LeA 5 vt 5 ,)-FF; 7" LA t J 71 110t! , oy - <br /> Proposed Use orBuMing Co,.at p Contract Price of Work e F <br /> Square Footage(If residential new Construction, remodel or addition) Contact Person/Contact Numbor/Email <br /> 3 to S8' ! - 34Fst� <br /> Number 4dWCes low Voltage) <br /> Description of Work to Be Done, f <br /> Vyl O � I a � Q� � S4-�r1 `� 1b c1�-d. I Vl <br /> f� r ��� �� �.~�r���� c�l.te. rte c,`.)�Q-�-,►� a�,y� �.�-�-�r'-e <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 C� oo <br /> 1 hereby certify that/have read and examined this application and know the same to be him and J <br /> correct. All provisions of laws and ordinances 9s009ming this type of work will be completed <br /> whether speciffed herein or not. The granting of a permit does not presume to give authority to PERMTi# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That lam authoriz by the owner of this property fo perform the E t-✓ <br /> work for which application is made and 1 comp th the State Contraotors Law 18.27 RCW and <br /> 29 00 WAC. <br /> Signature fe <br /> REVf3ED Oi08201t <br />