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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT:SERVICES <br /> 3200 CEDAR STRF-ET f VERETT,WA 98201 <br /> 425-257-88'10 - FAX 425-257-8857—wvrtiv.everettwa.org <br /> � ,�t <br /> PROJECT ADDRESS <br /> Owner Mall Address City 5tateZTp Phone <br /> i'enant _ Mall Address City StaterZlp Phone <br /> 4Z5-7 -811 q <br /> Electrical'Contmctor Malt Address Cfty State2lp Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> A?PromE& 9EMMf4, 32. 3 .00 _ <br /> `\ Proposed Use of Building Contract Price of Work <br /> WT14A4 WAt5MM 42 s-Z is 1'7oe4 <br /> Square Footage",(if residential neW constrZrction,remodel or addition) Contact Person)ContactNumber(Email <br /> Number o devlcos"(1f low volt..ge} <br /> Description of Work to Be Done: . '� ���� ...��2�� �.1t�CTj FIXT <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> /hereby certify that l have read and'exemined this appllcatlon and know the same to be truce and <br /> correct'Alt provisions of laws and ordinances governing this type of work will be completed <br /> whetherspeci ed herein ornot. The granting of a permit does riot presume to give authority to PERMIT# <br /> vlolate or cancel the provisions of any other state or•local)ew regulating gonstructlon or the E9 0/� <br /> performance of construction. That)am authorized by the owner of this property to perform the �'i C -- <br /> work for whldh dppItcation fs made-and I comply with the State Contractors Law 18,27 ROW and <br /> 286.200 WAC. - <br /> ne !e <br /> REVISED G&"170'14 <br />