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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.org <br /> b0-7 SG G4h Mat1 (iJLA/ _ <br /> PROJECT ADDRESS <br /> Rbbo uASou Ptro pe ten Sbo SS EpLMM 4twa it 13208 C-,,j-f- W11 987063 z425-353-6.0-60 <br /> Owner Mail Address 7 City State/Zip Phone <br /> hex- 5r=- ea mo v36.0 V -3y -2 <br /> Tenant Mail Address City State/Zip Phone <br /> �L PA jQ ci Co (MQ D 6&04E f(w y MI I reek- IAJ& 9 go y 2 �-FZS'3 S`1-kc[02._ <br /> Ele�al Contractor Mail Address City State/Zip Phone <br /> 3 <br /> State License Number(required) City of Everett Business License Number(required) <br /> C �Utd <br /> Gl171do <br /> PaU <br /> Proposed U of Building 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: V\N&6. / '!5�— Z (26\(. (J <br /> 5 � �e�ryt Z�yaQ rr�l�► <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 t �� <br /> I hereby certify that I have read and examined this application and know the same to be true and l <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 E I G <br /> performance of construction. That/am authorized by the owner of this property to perform the <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Wanda <br /> Signature Date <br /> REVISED 08/06/2014 <br />