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425-252-1666 c.m.heating 08:00:33 11-04-2015 <br />� �. <br />ELECTRICAL PERM(T APPL1CATiON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9B201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />�� � � �Y1c�c�'s �-u_ �-e., <br />�OJECT' ADDRESS <br />��,�1 <br />�mer <br />nant <br />�rn � • <br />;ctrical Contractor <br />P.lail Address <br />Mail Address <br />Mail Address <br />��m � �+g�7 �� <br />�te License Number (required) <br />�posed Use of Building <br />uare Footage (If residential new construction, remodel or addition) <br />City <br />City <br />City <br />State/Zip <br />Stale2ip <br />Stale/Zip <br />� o�S <br />Phane <br />Phane <br />Cnlnla (A <br />Phane <br />�� ��Q� <br />City of Everelt 9usiness License Number (required) <br />�' OL� � <br />� <br />Cantract Price of Work <br />Y�C9� �1r�f� �--Qe�/�-t2S ? �� oSso <br />f�-e�(` �Cxr��no�. c�r�n <br />Contact Person/Contact Numher/Em ' <br />imber of devices'(ff low voltage) <br />�scription of Work to Be Do�e: � I ��'�� `�-^``��-^"^-�-i <br />TY OF EVERETT LOCAL SALES TAX CODE 15 3105 <br />ereby certify that I have read And examined fhls applicafion and know the same to be true and <br />rrect. All provisions of laws and ordinances govQming this type of tivoric wlll be comp/efed <br />�ethe�speciTed herein ornot. The granting of a permit does noi presume to give aufhority fo <br />Jlate arcance! the provisions of any otherstate or local law regulating construction or iha <br />�rformance of construction. That I am authorized by fhe owner of this p�perty to perform fhe <br />�rk for which applicafion Is made and 1 comply with the State Contractors Law 18.27 RCW and <br />�6.200 WAC. <br />V15ED 09.otL.0/i <br />FEE <br />�C��� <br />PERMIT# <br />E (� ������� <br />2 /2 <br />