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low <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 /> 150( Se G eff�i Ma it WC.�1 <br /> PROJECT ADDRESS <br /> f f yrx 91tra G L.LL- 12-411 V j'ntua� 6IVA syUck 6 Li:bl, C f11 I L 6q <br /> Owner Mail Address City State/Zip Phone <br /> S;A9etCuA-'s 05 S E Ev?(e_ t+ Mull W� \_-_v-ert4 .W!\ CN aog <br /> Tenant Mail Address City tate/Zip Phone <br /> 3uo-r7 <br /> Atj ev b-)'01Q 244S 1k(,U�4 9"1 5► Hbib* \lei (n, l,tA\ <br /> Elect'cal Contractor Mail Address City State/Zip Phone <br /> gT1 jEgsc'ol 2 C 4 24 '116q <br /> State License Number(required) City of Everett Business License Number(required) <br /> X00 1 ©lam <br /> Proposed Use of Building Contract Price of Work <br /> Ste.�in�Y l.��qu►5 <br /> 5+;'421ri►� MP.u�'rSiGr1� 10'� <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/ ntact umber/Email <br /> �.i� <br /> Number of devices(If low voltage) 11 1 ' _I , <br /> Description of Work to Be Done: `'���1� � I`\ I\m c'T'c� f'lo Alam `' 4t✓ <br /> y;jf'll�5j/Y1 <br /> FEE n <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /� ✓� <br /> 1 hereby certify that/have read and examined this application and know the same to be true and (J <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/am authorized by the owner of this property to perform the t <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> '<-/-.Signature Dat <br /> REVISED 08/06/2014 <br />