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Aug. 11. 2015 9 . 34AM No. 0791 P. 1 <br /> 0 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVFRFTT, WA 98201 <br /> 425-257-8810 - FAX 425-2578857—www_everettwo.org <br /> PROJECT ADDRESS <br /> Owner Mail Address City StatalZlp Pnon3 <br /> l <br /> �.:, -✓ ' � ,,�, � � � .> arc ` der <br /> Tenant ely State/Zip Phone <br /> d � <br /> Eldfgjcal Cohtra-ctU Mail Add ss City SWOOP Phone <br /> Sta a iconse Number Contract Price of Work <br /> F6Sw � � jz�)�,f/ &e'19 <br /> Proposed Use of Building Co tact r n (Plan Review) <br /> , S <br /> Square Footage(If residential new construction, remodel or additlun) <br /> Number of devices(If low voltage) <br /> Description of Work to lie Done: G� /i (� U`�JJ G LA—, <br /> EEE <br /> CITY OF EVERETT LOCAL,SALES TAX CODE IS 3105 <br /> l hereby certify that t have road and examined this application and know the same to be true and ��✓✓��// <br /> correct. All provisions of laws and ordinances goveming this type of work will bo completed <br /> whether specified herein or not The granting of a pemrit does not presume to give authority to PERMIT# <br /> ytotato or cancel thB provisions of any other state or local law regulating construction or the <br /> pHiforrnance of construction. That I am authorized try the owner of this properly to perform the <br /> work for wh'ch application is made and I comply with the Stat© Contractors Lary 16,27 RCW and <br /> 296.200 C. <br /> i <br /> RC1 l <br /> S gnature Da y <br />