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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 /> 0/ <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Sv l� y2S='338-5"�bc> <br /> S I Lt✓rz lL t-0A9Z <br /> Tenant Mail Address City State/Zip Phone <br /> z-{2S-3V3-7(,P8 <br /> l�T� �CEI twtoZryl(.cOtZy� s Q. v Sox 1/S� ��l<f�►��, wd <br /> '7Y2 -7S- <br /> Electrical <br /> Y27S-Electrical Contractor Mail Address City State/Zip Phone <br /> Nr-?-W 'iIzcT- / S-�-- ►L 0 -33036 <br /> State License Number(required) City of Everett Business License Number(required) <br /> //'��__ + ��41/,0o <br /> l�C'�Wf^^^tR 0! kl L- <br /> Proposed Use of Building Contract Price of Work <br /> %a- 17 Gbo v rT J J 1�A tQ A s <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> J I tr l,L-A R A s & iVe +e e 4 ole,-4,41- Oe)),A <br /> J <br /> Number of devices(If low voltage) / <br /> Description of Work to Be Done: J�?5 CA I S^ VA (A Od &4s <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 o g (� <br /> 1 hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws 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 authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the d <br /> 5 <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 C. <br /> i <br /> Signature Date <br /> REVISED 08/06/2014 <br />