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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 425-257-8857—www.everettwa.gov <br /> 21f0Zerr rofQc��ctu <br /> PROJECT ADDRESS <br /> V I Sgttctt-ed 4,( C. W93 5,E zlfth , f�-Zt <br /> Owner Mail Address {' 7-54QYti -r W 4 StatefZip Phone <br /> krL,,-xe1ny;11e ZU4 <br /> Tenant Mail Address City Ll Staterzip 20&-9lvj,�hone <br /> yES6 a L LC 2A/0/ Fo-clA l cf(001 <br /> Electrical Contractor Mail Address City StatelZip Phone <br /> Y E<S C n L.*cto o LP ILLI h L ,t,z�32-0 - <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> r3Z C a t �a <br /> Square Footage(If residential new construction,remodel or addition) Contacts Person Contact NumberlErnail <br /> i <br /> Number 6f devices(If low voltage) n eY 1 CQ6; e, 'L.. t/e5rd. <br /> Description of Work to Be Done: �l (`�n n e� JA r e-C� 11 <br /> n a +�) )LO�ix— �J <br /> FEE p y <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Fd <br /> I hereby certify that 1 have read and examined this application and know the same to be true and <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 not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the ,dl , <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and Vr <br /> 296.200 WAC. <br /> 9-20-1Signature <br /> G1�� 1�� tQ55 VAC ��YA.r 15 po �OK lg �ly/��(�int7 a <br /> REVISED 080WO14 v c� C i Q'4 Z <br />