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425-252-1666 CM HEATING <br />06:36 p.m. 03-25-2015 3 /4 <br />ELECTRlCAL PERMIT APPLICATtON <br />C1TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98Z01 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa,org <br />3�0 S v� �-tmor��- <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical Conlractor <br />� � <br />Mail Address <br />Mail Addres5 <br />City <br />City <br />Mail Address 1 ` City <br />Cm��+g�7 b� <br />State License Number (requiced) <br />ropased Use of Building <br />Square Footage (If residenfial new consiruction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work io Be Done: <br />CITY OF EVERETT �OCAL SALES TAX CODE 15 3105 <br />� <br />8� � S31 5 80`7 <br />5kate2ip Phone <br />State2lp Phone <br />�2� 2�q Cnlo�fp <br />$tate2ip Phone <br />o� (�oq� <br />City of Evei'ett Business License Number (required) <br />z50 � <br />Cnt�tra�t Price of Work <br />Contact Person/Contact NumbeNEmail <br />I hereby certify that I have read and examined this application and know fhe same fo be true and <br />correct. All provisions of laws and ordinances goveming thls type of work will be completed <br />whether specified herein ornot. The granting of a permit does not presume to give authority to <br />violafe or cance/ the provisions of any ofherstate orlocal law regulating construction or the <br />performance of consfruction. That l am authorized by fhe oWner of this property to perform the <br />work for whi'ch applicafion is made and I comply with the Stafe Contracfors Law 98.27 RCW and <br />296.200 WAC. <br />I�I�t,� c <br />�-a �� i 5 <br />( 5ignature / —��— batw <br />REVlSED OB�9B/ZOf4 <br />FEE <br />� b�,6o� <br />PERMIT# <br />E � 5b� � ti`�1 <br />