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Jul 28 1507:14a Pure Power 2065098033 p.2 <br /> - 0 <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.gov <br /> 6) C71 <br /> D L) <br /> PROJECT ADDRESS <br /> © ice �! I o`Z UL 1��►�/ �ut72;7- <br /> Owner Mail Address P City StatelZip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> /J = I '1-. 5 AI�e l L,)/A C l I ZoG-iY -L Sk <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> pU �aP'L'69 P) 1",.-II � <br /> State License Number(required) City of Everett Business License Number(required) <br /> 1 Y)"7 �C '.4r o <br /> Proposed Usef Build og rrt�� /vv f7i5 � <br /> Contract Price of Work <br /> Square Footage (If residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(if low voltage) <br /> Description of Work to Be Done: ;�.� ti k ��n 2 L�na.r�7 cmc��c .� 3 .tti�� ✓ Ci�._ <br /> FEE /� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Cy��OWI <br /> V <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 the <br /> performance of construction. That 1 am authorized by the owner of this property to perform the E`4 l 5 6] —M <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> l� 21 71Z / <br /> Signature Date <br /> REVISED 0"612014 <br />