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ELECTRICAL PERMIT APPLICATION <br /> CITE' OF EVERETT PERMIT SERVICES <br /> x200 CEDAR STREET, EVERETT,WA 9820 <br /> 425-257-8810 FAX 425-257-88f7"—www.everettwa.org <br /> PROJECT ADDRESS <br /> Owner Mail Address C y 5tafetZlp Phone <br /> Tenant Mall Address city State/Zip Phone <br /> IE4z5- <br /> �V 6,4 to C (�o5 2DD" 'i 57" ;2W -I,Jt�isot � 'r gf X36 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> lk—Itye"'R Ms 02-6 2-x-1$ <br /> State License Number(re4lred) Clty of Everett Business License Number(required) <br /> Proposed Use of Building ContractPrice of Work <br /> AA-14-� WA C,WVW 142.-z1$• �?� <br /> Square Footage(if residential new co7struction, remodel or addition) Contact Person/Contact Number/Email m <br /> A <br /> Number of devices(if low voltage) <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 305 <br /> I hd`reby certify that i have read and examined this application and klrow the same to be 6ve and <br /> correct: All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified heroin 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 orlocal law ragulating construction or the ^� <br /> performance of construction. Thett am authorized by the owner of thls property to Perform the E <br /> Work for which application Is made and i comply with the State Contractors Law 18.27 RCW and <br /> 298.200 WAC. <br /> 5-19' I5 <br /> gna ure I tate <br /> REVISED 0&V&?014 <br />