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AL <br /> Mr <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 /> W$I-1 FV2r5,rUn W(Aj Siff .3 �Vere'ff <br /> PROJECT ADDRESS <br /> UWtMI4A VA\tno-S�a�c;o�LLG 11541 M'&A1KU' ')[ C,int�nnv OR I Lis z4q <br /> Owner Mail Address City State/Zip Phone <br /> Tena Mail Address City State/Zip Phone <br /> Uc I S-11" S-r ►,1w 5-mc Artim',A WA�98ao� Zs3-Y87-59ol <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Nft-5C-J230P <br /> State License Number(required) City of Everett Business License Number(required) <br /> 3 ooa <br /> Proposed Use of Building Contract Price of Work <br /> 9(o . 3-75 5g-Y+ Rala�-� Sam-i'oS /f1sl•sG.n+os.rb <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Numbe/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: o W a 11 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 G® a 6 <br /> I hereby certify that t 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 I am authorized by the owner of this property to perform the E ( ' 07 <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Z 1 /2-6 i5 <br /> S gnat re ate <br /> REVISED 08/06/2014 <br />