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FA,,,e <br /> 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.org <br /> 13'21 Coc.6y <br /> PROJECT ADDRESS <br /> PP'VV10MmCt-: PO goo 1067 tr �A 9'3206 LJ2s=2r�,r-_,`>'1r3 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> ARONSO 4V S 0 S`E'T"( �r3!' moi:0',r 100 � �-rylY (30005-1 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> AkaN.s5G o 13C lt, 4ILt qq <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person.(Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: TE5fA" . L45U.10 VoLtActa S 'TY $YSMM- SE4 <br /> FR CLASS DoQe� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ' <br /> m <br /> I hereby certify that I 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 theE5 15 — <br /> �®06 <br /> performance of construction. .That t am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 98.27 RCW and <br /> 296.2A WA//C. 2 U CS"714 ¢ <br /> Signature Date <br /> Pty:i .�9�cN A2c�l�s��=slrc�a s' r cc/A PAx 20w« Z ai "1"fit <br /> REVISED 320/1� <br />