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Nov, 17, 2015 7 ; 45AM No. 0886 P. 3 <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.oi-g <br /> PROJECT ADDRESS <br /> Ct(,V\ c1� 1�� C.��`(.,�/�1 '1,'ti. {-�;C�.1: `" GCS! �t ZJ - q <br /> �:J <br /> Owner Mall Address Clty Statel7_ip Phone <br /> Tenant Mail Addross City State/7.ip Phones <br /> F-foOtriC�I Contractor Mall Addross City Statet7.ip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> -t:,���r.J��'�-�-7 cam:• �(;�(t ° �'" C <br /> Proposed Use of Building Contract Price of Work <br /> Squaro Footage(if residential new construction,remodel or addition) Cot)-46t Parson/Contact Number/Email <br /> NUmbor of dovicos(If low voltage) <br /> Description of Work to Be Done: �:��r.__z, ver\ `,�(/i(. C"a.a"( .......... <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that/have read and examined this application and know the samr,to be true,and U <br /> correct, All provisions of laws and ordinances governing this type of work will be Completed <br /> whelher specified herein or not. The granting of a pe►mit loos tzot prrsumc to give authority to PF.RM IT# <br /> violate or cancel(lie provisions of any other state or local law regulating construction or the <br /> performance of construction. That l am authod7.ed by the ownor of this property to perform the E <br /> work fol•which application is made and/comply wilt)the State Contractors Law 18,7.7 RCW and <br /> 296.200 WAC. <br /> Sign Iurr�.�M Date <br /> xtvrsrrinrvnw�ota <br />