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ELECTRICAL PERIVIIT �PPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CE�AR STREET, EVERETT, WA 98201 <br />425-257-881 � - FAX 425-257-8857 — www.everettwa.org <br />:`) �'� � j ��.`������ -�-l/� <br />PROJECT ADDRESS <br />� <br />` �� �?,�1 �%u r►-+,�-� c / SO �� �5��:.v� �� �v� � v'Z/'� �t �✓/1 ��� C ='-� �1��' ,�`.��- yC i 3 <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip Phone <br />�,�+�'! � �5�.;'n P_ �� CjU � �; 13 � � ^ �inf� c. :g � /} rl�, � ; j-�.,, �v-rC� i� � �.1 '-� ZS Z3 �'- �-17 6 i <br />ElectriCal Contractor Mail Address City , State/Zip Phone <br />��;� C�C � J ��! !-)� <br />State License Number (required) <br />C�,�1�i�c'd I u� =�• <br />Proposed Use of Building <br />�S�'., �� �, r <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />'�� 3 / �<.� � <br />City of Everett Business License Number (required) <br />�i ,�n �'� <br />�, � ,�, <br />Contract Price of Work <br />,;�CO/� �'lZ$-c.�G����L� <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: %%� � �G-h L.�•� f,j c � y'7r; ,` <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby certify that l have read and examined this applicatron and know the same to 6e true and <br />correct. A11 provisions of laws and ordrnances governing thrs type of work will be completed <br />whether specified he�ein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating constructior or the <br />performance of construcfio�. That I am authorized by the owner of this property fo perform the <br />work for which appli oiv�s made and I c y�vvitlT7� State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />/� � <br />��'l-� �-� ` 1 �� 1 �l�l <br />REVISED 08/O6/2014 <br />FEE <br />�� � <br />PERMIT# <br />E � `�� Z� � � <br />