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AUG/03/2015/MON 12: 57 PM FPI Seattle FAX No. 4252909600 P. 001/001 <br /> ELECTRICAL PERMIT APPLICATION <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 /> 10101 jqi-h <br /> 6 <br /> PROJECT ADDRESS <br /> Owner Mail Address City Stateop Phone <br /> k�nd hot vin ?.0 e r,,a Ye Cnint i o i o i �g-h pve_s, ,< is <br /> Tenant Mail Addraaa City statelzip Phone <br /> rq)z Prt kch ori Inc, R) PDX 1 _t D H 2 , 1�. 1 I T 60%-z qZ5.2-410,9t000 <br /> Electrical Contractor Mail Addresa City State/Zip phone <br /> rf_1a 1?1 * ()I I t-A k_- 062a I L-1 <br /> StataLicense Number(required) Cit of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Con#ac�t P�e'rrnon! ontact Number/Small <br /> J J <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: ����� ' iy 1 CIA r <br /> N ay <br /> J <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of Jews and ordinances governing this type of work will be completed <br /> whether specified herein or not The granting of a permit does not presume to give authorky to PERMIT* <br /> violate or cancel the provisions of any other state or local law mgulating construction or the 1 <br /> patformance of construction. That I am authorized by the owner of this property to perform theE [5L* <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and V <br /> 298.200 WAC. <br /> zo i f2 <br /> Sigijiture Oat <br /> REME0 09/082014 <br />