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Ap r, 28, 2015 3; 31 PM No, 9062 P, 2 <br />ELECTRICAL. PERMlT ApPLICA`TION <br />CITY OF EVERETT P�RMIT SERVICES <br />3200 CEDAR S7REET, EVER�TT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�,c;Z2 -i�►` �71n lCc-�nd � -� �. <br />PROJ�C7 ADDR�SS <br />�'i <br />Own�r <br />Tenant <br />Mail Address <br />Mail Address <br />Clty <br />Clry <br />PhoL�3� j�� ( ^� <br />f` �� <br />Sldte/Zip Phone <br />��� �-�,t c�i v�sz � � n'� �a �e �+�' i�i� ' �ih.�"��" I ,c.� ��� � `'( Z S =7 � 7� �-(Ll <br />EIeCt�ICal ConffaCtof � Mall Address City State/Zip Phone <br />��',.T'-�S��-tg��U�� - <br />5tate License Number (required) <br />.. � <br />Proposed Usa of erailding <br />Square Footage (If residential new construction remodel or addition) <br />C <br />Number of devices (lf Iow voltage) <br />City of Everett 8usiness License Number (required) <br />� ���DD <br />Contract Price of Work <br />Description of WorEc to B� Done; _ �� "� �,-�- ; . . ���� -� � G . <br />CITY OF EVERE77 LQCAL SALES TAX CODE IS 3705 <br />I hereby certify thaf l have read and examined this application and know rhe same to be true and <br />correct. AN provisions of laws and o�dinances govem/ng Ehis iype of work will be comp/eted <br />whether specified herern or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other sfate or local !aw regulating construe!!on or the <br />pertomrance of constracilon. That I am authonzed by the owner of this property to perform the <br />work for whi application is made and / comply wlfh the Sta f� Contractvrs Law 18.27 RCW and <br />296.200 C. <br />' rl I .n..l'.� �. <br />REVISEO O6mC�2o14 <br />FEE <br />/.� <br />�1� <br />�� <br />PERMIT# <br />E ��(��x-��-��� <br />