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JUN/03/2016/FRI 02: 54 PM FPI Seattle FAX No, 4252909600 P, 001/001 <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 /> S u �-e_ 3tp� 11(1 <br /> PROJECT ADDRESS <br /> i —COe A-Z in> Ll..021W y---, I �c Feu 1r�1 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address city State/Zip Phone <br /> )cc, PC) �X, ��,�`4"� ��1�19 A Q l9L �c�,-2-qU- <br /> Electrical Contractor Mall Address city State/Zip Phone C <br /> E12 f--1'(�2-3-M?- a q3 14 <br /> State Licenso Number(required) City of Everett Busi ess License Number(required) <br /> Propo d Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact NuYnber/Email <br /> GLQ[ain <br /> 'p1 Se�-tv\p- .CCr <br /> Number of duces(If low voltage) <br /> V <br /> Description of Work to Be Done: iA m-�n 00 S:a-� W-L-A CO <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> If hereby certify that 1 have read and examined this application and know the sane to be true and `� 1 <br /> correct. All provisions of laws and ordinances gov©rning this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not prosume 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 3-7 <br /> work for which application is made and I comply the State Contractors Law 98.27 RCW and lr%V <br /> 296.200 WAC, <br /> LoSigna <br /> REVISED 08/062014 <br />