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ELECTRICAL PERMIT APPLICATION <br />�?+� , �=;,, � � �� �. � � �. <br />PROJECT ADDRESS <br />Owner <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 />��: _�� �-i�,��r <br />Mail Address <br />z_ <br />�;1`f'/V �� 1'G�, I V► i.�� I r'� 1� <br />City <br />State/Zip <br />Phone <br />/1 j�; a <br />�_r�.�-R- �-�v.�rk.-�- ��(,�v�.��- =�`"�V� �`l.�'�'1' i� ,,�� �-.'./�J-t..ti� .�/�! c;� 'L� �.Z..,—� Z.,�N...- <br />� . � � �, �^ � l � �a �z-, <br />Tenant Mail Address City State/Zip Phone <br />�,rYti,;C,�i�i��V��� �o;v�ptitl.a_Vl��c �i. ;v�•:� �(�L-, �=; ,� I ,-� �,..,�,4i���t�.;�_.V-� �J!�� �(v 1-`t1 i'f1S-����i- 1-� - <br />Electrical Contractor Mail Address City State/Zip Phone <br />j . ` ; " -4�`- �'-� � , �, v <br />State License Number (required) <br />r � <br />(_-- i �, , r_ <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />,.- � � L- <br />Number of devices (If low voltage) <br />�. '",� Ci r� 4_ '.�- <br />City of Everett Business License Number (required) <br />�� <br />�. =� �>, yl '>`�.` <br />Contract Price of Work <br />. � /\�'� 1 i ��. �1 J �- � �< . t, �� �.- .. � < 1 - � � : �d -� <br />Contact Person/Conta t Number/Email <br />���.�.,-�:i�;.�4�..K� C: c��:r-Fv,.��turecl c�.i^ <br />Description of Work to Be Done: L�- �� �-• �' ���`ti'� � l�-S �-`4-�h ��'�l a� C�-%t�� ,--� �-�--�� . <br />��'y' �� � L-r-� (i� ( i,vvL^,�V(r (; G�,�!J�..�- `� . ��JZC�-ir--r v" cr.t�=`��� �-i%1 , (,L LC.�`i< ��--i.'� C� <br />� U <br />; r�-�v't,-�. %7 ����� (�_ �: �,. �f�> �. � <`�; <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 fo 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 <br />violate or cancel the provisions of any other state or loca! law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the Stafe Contractors Law 18.27 RCW and <br />296.200 WAC. _ <br />1 "�� i.�G / ,� <br />REVISED 08/O6/2014 <br />FEE <br />� l�lb°� <br />PERMIT# <br />E1��S�� 1 <br />