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Feb. 29- 2016 3 : 39PM No- 2084 P. 3 <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.evereftwa,org <br /> PROJECT ADDRESS <br /> �s <br /> Owner Mail Address ity state) li, Ptroiso <br /> Tenant Mail Address city StalLIZIP Phone <br /> :16 I'M'310 <br /> F-loctrical Contractor Mail A(l(fross City State/Zip P110110 <br /> State License Number(required) City of Everett Business License Number(required) <br /> R L(111 U.10 -.— <br /> Proposed Use of Building Contract Price of Work <br /> Square rootage(If residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> W—Ifn6e-r of devices(If low voltage) <br /> Description of Work to Be Done: (•1' <br /> 41 \x <br /> ...... ... .... <br /> FEE <br /> CITY or EVERETT LOCAL SALES TAX CODE IS 3105 0.1 <br /> 1hon-by certify that lhave I-Qadand 0Xaminvd 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 ora permit does not prosume to give authofifyto PERMIT# <br /> violate or cancol the provislons of any other stoic or local law regulating construction or the <br /> perfortriertueo[construction. That I am authorized bythe ownorof this property 10 perronn the El 0 03 J Urv-1 <br /> work for which application is made and I comply with the State Contractors Law 16.27 RCW and <br /> 296.200 INA 0. <br /> Signature i!aLQ <br /> RE517SEDOWWO74 <br />