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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 /> Cf-.-e.., U <br /> PROJECT ADDRESS• <br /> 12e�,ey?rA, <br /> // - -#1 G/o IZZOZ <br /> Own r J Mail Address City State/Zip Phone <br /> Lss"CQc Playa <br /> cAl2LA C-1( r ;; ��1 ��U , t✓yes� � a C(`tS� <br /> Tenant Mail Address ` r City State/Zip Phone <br /> `,, Wa3z�s'3Z8-& <br /> ��`7y��V)f; f� A���y� S✓r ZOO /1�r /J �5 le �t`rSl��f f c�'� <br /> Electrical Co tactor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Tzvl SfGw a� <br /> ©CSC •f- C7OG)�t36— 3� Z �s werFC�w��nrr,{r.✓/�i� �� <br /> Squa a Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) 60" <br /> Description of Work to Be Done: T ��2�.� r?� 2�� ski �Inc, ,�l4 /2✓v✓I <br /> C00 s5U46041 i P-t 1/7 �0u 00—V'CPC '(Y Ce/4/-uc.f1'C)0 . LI-vim <br /> t A/10i7' Q h} �, <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ` <br /> 1 hereby certify that I have read and examined this application and know the same to be true and ` V <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 construction. That/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 1 J l t <br /> 29f,2"c. <br /> Sig ature Date <br /> REVISED 08/062014 <br />