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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.gov <br /> PROJECT ADDRESS <br /> P,O,NE1J 3V-1- 41I alkAsbc3���r�� �.c_ pct (30K 5 003 BELL VvSr .0/1 9000 <br /> Owner Mail Address City State/Zip Phone <br /> P42L +-%` EVEREi T IAA E'W7j'�Ti UA '?ZZULf 266-W2,-?e)70 <br /> Tenant Mail Address City State/Zip Phone <br /> AA7 I-JL-0 4C <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ADv'41�-J SL c?2-3 LV <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> 0A6a,,4 iAYI-O✓L 25-3-5e'7- 5-10? <br /> P ,yr4A5L-7Ak-L.y!.J�6MAlL-.6c�,K <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> 2- <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: I I_ L-L.;;-,I NAL <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 [� �J <br /> I hereby certify that I have read and examined this application and know the same to be true and c/ <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 r <br /> performance of constriction. That/am authorized by the owner of this property to perform the t I <br /> work for which application is made and l comply with the State Contractors Law 18.27 PCW and <br /> 296.200 WAC.- <br /> _ <br /> ry l <br /> Signature Date <br /> REVISED 08/06/2014 <br />