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4253423646 11:03:57 a.m. 02-24-2015 1!1 <br />� f <br />ELECTRICAL PERM[T APPLtCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 982Q1 <br />425-257-8810 - FAX 425-257-8857 — www,everetfwa.org <br />13 IS ����Es qv� <br />PROJECT ADDRESS <br />W11C�E� i�t�0��a��1 1315 GF�KEs.�vE <br />Owner Maii Address <br />Tenant <br />�11,J N �t2 <br />Electrical Contractor <br />State License Number (required) <br />Praposed Use of Building <br />Mail Address <br />Mail Address <br />Ev��� <br />City <br />5quare Footage {If residential new construction, remodel or addition) <br />Number of devices (If low volfage) <br />City <br />City <br />w� ��z�� <br />Sta►e2ip <br />State/ZEp <br />State2ip <br />�13�(-��z�6�3 <br />Phone <br />Phone <br />Phane <br />City of Everett Business License Number (required) <br />Con#ract Price of Work <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: � b� ���7 UN �.A�-qG£ GEl L11� G FL�2 C,�{Z,AC E <br />bU(1� D�PENEiZs. <br />CfTY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby certify tirat / have read and examined this application and know the same to be true and <br />correct, Al/ provisions oflaws and ordinances governing this type of work will be completed <br />whether speci�ed herein or not. The granting of a permit does noi presume to give authority to <br />violate or cancel the provisions of any other state or local law regulafing construction or the <br />perforrrrance of consfruction. That I am aufhorized by the owner of this properfy io perform the <br />work for which application is made and I comply with the State Contracfors Law 18.27 RCW and <br />296.Z00 WAC. <br />Z/Z,y � s <br />Rews� oaroano ia <br />FEE <br />�� � <br />PERMIT# <br />E ����� � �� <br />