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b.. ...........ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 88201 <br /> 425-257-8810 FAX 425-257-8857—wmv.everetfwa.org <br /> PROJECT-�ADDRESS <br /> Owner Mail Address Cfty Stata/ZTp Phone <br /> Tenant Mail Address City stet;afzfp Phone <br /> �JNW60t19_Wpir <br /> G <br /> Electrical Contractor Mail Address City staterZip Phone <br /> TiV $SN4S 02 6?=q <br /> State License Number(requfred) City of Everett Business License Number(required) <br /> A1PPry,-TmEAT &E-mm 0325 .00 <br /> Proposed Use of Building Contract Price of Work <br /> _ tJAV4Ak WACIMM_L12s-2i8 1104 <br /> Fo <br /> Square otage'(if residential naw construatlon ,remodel or addition) OontactPerson/Contact NumberlEmall <br /> 0 LA <br /> Number of devices (if low voltage) ;7 <br /> Description of Work to Be Done: E-X IST IN& 1-166 FIX I <br /> FEE.—.� .�_. <br /> t CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ? <br /> I heroby cefflfy that 1 have read and examined thisYapplicatlon and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this typo of work will be oompleted <br /> whether specified heroin or not. The,granting of a permit does not presume to give authority to PERMIT## <br /> violate orcancel'the provisions of any other state orlocal faw regulating construction or the <br /> performance of construction. That 1 am authorized by the ownerof this property to perform the <br /> wRtk for which application Is made and I comply with the State Contractors Law 16.27 RCW and <br /> 286.200 WAC. <br /> _._.._.. <br /> Signature Date <br /> REVISED 0$+G ?0 td:... i <br />