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425-252-1666 c.m.heating 13:22:48 12-04-2015 6/6 <br /> • • <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—wr,pr i.everettleia.org <br /> 1 <br /> IECT ADDRESS <br /> Mall AdJras-3 Z City St3:e2ip Prone <br /> CMail Address Cit, State/Zip Phone <br /> W h 5 <br /> ,al Contractor Mail Address I City Sta'erzip Phone <br /> GI�IF-AM bt-J o I ct7 oR 9 <br /> 'cerise dumber(required) City ofEverettBusiness License Number(required) <br /> =12L.L� <br /> ad Use of Building Contract Price of rk <br /> Footage(If residential nasi construction, remodel or addition) Contact Peron/Contact NumberlEma:l <br /> of devices(If low voltage) <br /> tion of Work to Be Done: <br /> FEE <br /> NO <br /> EVERETT LOCAL SALES TAX CODE IS 3105 <br /> certify that I have read and examined this application and know the same to be true and <br /> All provisions of laws and ordinances governing this type of work will be completed <br /> specified herein ornot. The granting of a permit does not presume to give authority to PERMIT# <br /> ircancel the provisions of any other state or local law regulating construction or the <br /> ince of construction. That 1 am authorized by the ownerof this property to perform the <br /> which application Is made and/comply with the State Contractors Law 18.27 RCW and <br /> WAC. <br /> AqI I 5 <br /> Signature Date <br /> tcasoi� <br />