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ELECT�iCAL PE <br />RMIT AP ICATIOIV <br />CITY 4F EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �t/ �:�..���' ..;� r�'�=��-�r: �' �' ��'�� - �j�.,7 .'" <br />sJ' <br />� 3e�.r,� � i '. � �L ���r�.e �j � ��J � ti�-j�L-Y'� ,:�J�a- . �,� � � � <br />�.,� <br />, � � <br />l ' � ? 'i <br />PROJECT ADDRESS <br />-thVa <br />Owner <br />Tenant <br />r :.� <br />.`, r° ^' ,_ <br />d a ��� � h,��i-? <br />Mail Address <br />G���Nf�'v'����t ��.',r �; <br />Maii Address <br />� ��1��� <br />City <br />City <br />L--%�� % � 'L �' I <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />,y <br />t' �'1.���� i,��; ���,cc z.:�� � L P� r>� `-t � z( ,'; r^-� ���,..>> � t' �=, �' <br />l� V f ��" �" � �h1 �i . I V C�� .5 � �'J v ti�� L Z' GL'� � 7i <br />EleCtflcal Contractof Mail Address City 5tate/Zip Phone <br />}�''� • �- l�i�i l. t a- ,� � `G 'l.i�� � C'�'� (: ( � <br />State License Number (required) City of Everett Business L.icense Number (required) <br />c� �1�' `�' 2� V �� <br />. �, <br />� �fJiG�i:�,�� i.�a r <br />Proppsed Use of Building Contract Price of Work <br />Square Footage (If residential new construction, remodel or addition) <br />� <br />Number of devices (If low voltage) <br />_� C"�t�u� �c�%1 i�3 T'S' c- r�w ��� �:rL �. ,v �; e.i rvv_ , t <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: _ ��5�'�`=1�L C��e "• �� 5-�V i N, t"��-:��.t�y��7�,•:�_ 4-�. C <br />�;(. 7' c. i�, ,�1'. �. ;,;_� -r... j i <br />1`���`T(-1 i—� i� ��j I!j'i ;V i.:,�� �-L:>L i� � 9 e,' � s s .�� <br />CITY OF EVERETT LOCAL SALES TAX CQDE IS 3105 <br />I heieby certify that l have read and examined this applicafion and know fhe same to be true and <br />correcf. AI! p�ovisions of laws and ordinances governing this type of work wrl/ be completed <br />whether specified herein or not. The grantrng of a permif does not presume to give authority to <br />violate or cancel the provisions of any othe� state or local !aw regulating construcfion or the <br />performance of consfruction. That I am aufhorized by the owner of thrs property to perform the <br />work for which app/icatron is made and l comply with the State Contractors Law 18,27 RCW and <br />296.200 WAC. <br />r <br />,�'. r`, <br />e:; f <br />REVISED 08/06/2014 `�, �' � � �\ � I_,{ ./1 <br />__ _ !✓ r U ! f i' � <br />FEE <br />'� �lJ ; �sl <br />P�RMr,-# <br />E (���-���� <br />