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0 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.org <br /> 2,g 0 PSD ,/ AV, 4 re- <br /> PROJECT ADDRES <br /> Noox''`- W�Si Q,N�t rdm <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address n. City State/Zip Phone <br /> t'l v � L �cc�J1'r�a t 0 L`J rtr S �a� �t���^'� l�-� �} �2S�S �S� ZZ3 3 7S <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> `I q <br /> State License Number(required) City of Everett Business License Number(required) <br /> 9 o0 . o C) <br /> Proposed Use of Building Contract Price of Work <br /> ea+T�&(-- V,?S 9Z-3 3'T <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) I <br /> Description of Work to Be Done: <br /> S w c v A_ vvtLV <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 l,fj� �GJO <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 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 l am authorized by the owner of this property to perform the <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> nature Date <br /> REVISED 08/06/2014 <br />