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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 425-267-8857—www,everettwa.org <br /> L `C JEy= WA- <br /> PROJECT <br /> 114 PROJECT ADDRESS <br /> Owner Mail Address city Siateop Phone <br /> Tenant Mail Address City State/Zfp Phone <br /> Electrical'Cbntractor Malt Address City:, State/Zip Phone <br /> tV��OS$MS 4262.E-l�' r <br /> State License Number(required) City of Everett Business License Number(required) <br /> AF i .32-5 .oa <br /> Proposed Use of B Ilding Contract Price of Work <br /> MA1104 WAt:1W94A q2-S-Z18 x-704 <br /> Square Footage(If residential new constMctlon,remodel or addition) Contact PersonlContact Number/1=ma11 <br /> e o de Ices If low volts e <br /> Numb r ( 9 ) r <br /> Description of Work to Be Done; �� y °� ��� 1►?�• �(ST I��& 1-1( ' t f FIX f�}— <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105' <br /> 1 hareby'certlfy that have read and examined this application and know the some to be tare-and <br /> correct. All provisions of laws and ordinances goveming 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 lace/IoW regulating construction or the 5 O <br /> performance of construction. Tifpt lam authorized by the olvner of thls propefty to perform the E �� <br /> work for which application is made and l comply with the Stara,Contractors Law 18.27 RCW and <br /> 286.200 WAC. <br /> 5-I<i, <br /> Signature _.. __ Date <br /> REVISED OaWV2814 <br /> ......... <br /> 9 <br />