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Amk .Mal <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 /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Pr-,a►�tr's L3ANK �� �30� a33 LYq�0 !,>,j ifa` <br /> Tenant Mail Address City State/Zip Phone <br /> DAv4 L EL.E.0 TOLL- 3kolt 810.,.atALL Ailk E v ..�&w- r 19 <br /> Electrical Contractor Mail Address City State/zip Phone <br /> i A14LEP-1 rAIL.08 c a � <br /> State License Number(required) Cit f Evere ness License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> UIS�e-ytv►S & <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: /JSTf/}Lf— j Ext lu.�IDiQ �5 C GAS t L 14-If T 5 <br /> /aN10 trJiavis tyK- Aly)V) 14 T- LIt—14t5. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 O U <br /> I hereby certify that/have read and examined this application and know the same to be true and 1 <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 t <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC <br /> Signature Date <br /> REVISED 08/06/2014 <br />