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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.gov <br /> Y10 7 2 1-/ <br /> PROJECT ADDRESS <br /> U liyA t182Q3 <br /> Owner Mail Address City State/Zip _3d,7Phoy�e,�l] <br /> Tenant Mail Address City State/Zip Phone <br /> TSSAjq '� <br /> -20 !�^ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> X62/aEr C/ 53 Z> V/ 0"�;-1 3 5-D <br /> State License Number(required) City of Everett Business License Number(required) <br /> /!ES/ /2e m c) . ��6. O CA <br /> Proposed Use of Building Contract Price of Work <br /> RYAN /YlC-,Q/1" Zod <br /> All <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Co act Number/ mail <br /> /VGiVe— <br /> Number of devices(If low voltage) / // <br /> Description of Work to Be Done: -�/1/5 � A/-e J rA7V 4t h7� �i(�/�'LL �Ce ars &Af6A S <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 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 <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. 00 WAC. <br /> Pj'�4c_ /�,'A //— <br /> Signature Date <br /> REVISED 08/0612014 <br />