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05/21/2015 13: 09 3604740126 DONNELSON ELECTRIC INC #3420 P.001 /001 <br /> Adm. AND. <br /> IW 11MW I ! <br /> ELECTRICAL PERMIT APPLICATION <br /> II <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 f <br /> .25-257-8810 - FAX 425-257-5857 —vwvw.everet!wa.org <br /> I <br /> t - 1 1� Ave. <br /> PROJECT ADDRESS <br /> ljo&-ev 39115'N "(Om"ey-Ave. Eyere4 WA 922 <br /> I <br /> Owner Maul Address City State/Zip Phone <br /> Tenant Maif Address City State/Zip Phone <br /> r <br /> ' V- 1re1 , �Elec-r-c rc ;39 A'' j.;L4v✓si`!C �e �Y11��icy) !1v'; �"UZGJ 3(,O-YSS S- <br /> 6 <br /> I Electrical Contractor Mail Address v City State/Zip Phone <br /> 1 State License Number(required) City of Everett Business License Number(required) <br /> Sad _rvr_ � <br /> Proposed Use of Building Contract Price of Work <br /> �aLame S&L z4z5 f 2vr <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email 51CU- f ai <br /> Number of devices (if low voltage) <br /> I <br /> I ��e <br /> 1 Description of Work to Be Done: yfir : <br /> f - <br /> I <br /> FEE f <br /> CITY OF EVEREI'T LOCAL SALES TAX CODE IS 3105 4 <br /> I hereby certify that/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 lam authorized by the owner of this property to perform the <br /> work for which application is made and/comply with the State Contractors Law 16.27 RCW and l r <br /> 296.200 WA <br /> tVzz/15 <br /> Dilte II <br /> REVISED 08/06/20�a I <br /> I <br />