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Ma r, 11. 2015 9: 36AM No, 8667 P, 3 <br />ELECTRICAL PERMIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa org <br />Z�I � c�G �� � ��,� � ���C.� <br />PROJECi AbbR�55 <br />Owner <br />Tenant <br />Mail Address <br />Mdil AtldfeSb <br />Cify <br />c�ty <br />5tate/Zip <br />StatelZip <br />_ �� .� <br />Pnone <br />Phone <br />6�S �or�k,� 3�Ir�� �ivrQ�,� �,�x�� G����� ura -7�—�t�a�„ <br />EleCtrical ContraCtOr Mail AtltlreSs City State/Zip Phono <br />C�S �s�i°� <br />State License Number (required) <br />�-eS, d,�� � <br />Proposed Use of Building <br />I (N � <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (lf low voltage) <br />D@scription ot Work to 6e Done� <br />City of Everett Business License Number (required) <br />Contraci Price of Work <br />ConEact PBrson/Contact Number/Email <br />- � ._... ��� "�_��►� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby cerfify that l have read and examined this application and know the same to be true and <br />co�reci. All provisions oflaws and orclinances governing fhis type of work wil/ be comp/eted <br />whether specifred herein or not. The granting of a permif does not presume to give authority fo <br />violafe or cancel the provlslons of any other sEate or local law regulating construction or the <br />performance of consfruction, That l am authorized by fhe owner of thls property !o perform Ehe <br />work for which appfication is made and 1 comply wifh the State Contractors Law 18.27 RCW and <br />296.200 WA . <br />�I�l/�� <br />REVlSED OH�92014 <br />FEE <br />-T�o � <br />PERMTT# <br />E I� �3 �5D <br />