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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -Wwweverettwat.org <br /> - Lt DEA ST- it WA-c?82.01 <br /> PROJECT ADDRESS <br /> C% <br /> Owner Mail Aqdress City Statelzip Phone <br /> Tenant Mall Address City StateiZip Phone <br /> L425-774�-811-9 <br /> A�--n,\)4� IaNXI&I'Elalt�& (0�5 r2bD-rt�sl- 6vi L-wovjbob- Wpr qsssG <br /> Electrical Contractor Mall Address City State/Zip Phone <br /> I AcTive- gms 02-6 2-q B7 <br /> State License Nymber(required) City of Everett Business License Number(required) <br /> A? --TmEAT &�mfnL <br /> af <br /> 'Propo ad Use of Building 0,ontract Price of Work <br /> AA,11-" WAC%wA,.J q2-c5-ziB- I <br /> Square Footage(if residential new constMction, remodel or addition) Contact Persor-dContact NumberfEmall <br /> 01A <br /> '�i-um6-e-rofd­evlces(Iflow—V086-e) <br /> Description of Work to Be Done: j6,H17 FIXT <br /> FEE- <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 60 <br /> I hereby certify that/have read and examined this-appiloation and know the some 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 orlocai law regulating cunsb-uctlon or the <br /> performance of construction. That]am authorized by the owner of this property to perform the E <br /> work for whic!)application Is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> is <br /> REVISED OaVa20t.4 <br />