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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 426257-8857-www,everettwa.org <br /> PROJECT ADDRESS <br /> T— 0:51A) CN A01ROfWT <br /> Owner Mall Address City Stateop Phone <br /> Tenant Mall Address City State0p Phone <br /> >}25-77*-81 q <br /> Electrical Contractor Mail Address City Statemp Phone <br /> perly $'tis 02.62.44!6 <br /> State License.Number(required) City of Everett Buslgess License Number(required) <br /> Propca edUse of uilding Contract Price of Work <br /> Jl1AVA13 WA L 11. 1 '425--ZIB-T704 <br /> Square Footage(VAK&'itlal new construction, remodel or addition) Contact PersoWContact Nu—mber/Email <br /> ,O �y, l <br /> Number olds Ices(if low valt8ge) <br /> Description of Work to Be Donee _E"� V� J R`8g E-X l ST JIT. l_16 E FIXT <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 be true and 115 (}0 <br /> l hereby coral that'l have read and examined this application and know the same to <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 riot presume to give authority to PERMIT# <br /> violate orcancel the provisions of any other state orlocai law regulating construction or the r 0 <br /> performance of construction. That 1 am authorized by the owner of this pmperty to perform the <br /> work for which application is made and t comply with the State Contractors Law,46.27 RC W and <br /> 296,200 WAC. , <br /> f LR, .t,�.�•. 5-19, 1S <br /> �lgna ure Date <br /> RBNSI:D 08'6870f 4 1 <br />