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From:Janes Company 425+267+0303 04/2014 14:23 #824 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 /> /\v(! W _ <br /> PROJECT ADDRESS <br /> G-)1W CV)CAV LAA <br /> Owner Mail Address City ' State/Zip Phone <br /> cl)cm2io 510-2,33 1-d vi re , w� ac 203 ( y�'�7? <br /> Tenant Mail Address City State/Zip Phone <br /> Electn��wc� <br /> Mail Address City State/Zip Phone <br /> J AN CCK1019 P 2 45-0 . 00 <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage (If residential new construction, remodel or addition) <br /> t <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: 1 Yls-fa oncd C� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that/have read and examined this application and know the same to be true and U f <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/am authorized by the owner of this property to perform the C/ UI r <br /> work for which application is made and 1 comply with the State Contractors Law 16.27 RCW and <br /> 296. 00 WAC. <br /> A OA:::� AIX"--' 4 <br /> - Z5 —) <br /> ',64nature Date <br /> REVISED 3/20/13 <br />