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OCT/16/2013/WED 08: 20 AM FPIttle FAX No, 4252909600 P, 001/001 <br /> ELECTRICAL AP-Get PDF.aspx 6 0://www.everettwa.org/Get_PDF.aspx?pdffD=35 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF E'VERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, E VERETT, WA 98201 <br /> 425-257-8010 - FAX 425-257-8807—r/WW.i3varettwa.org <br /> PROJECT ADDRESS <br /> 'k-7-9 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City Statoizip Phone <br /> Z - �►O_c4 boo <br /> Electrical Contractor Mail Address city State/Zip Phone <br /> State License Number Contract Prilce of Work <br /> Proposed Use of Building Contact Person (Plan Revlsw) <br /> Square Footage(If residential now conslructiOD.remodel or addition) <br /> sl� <br /> Number of devices(if low voltage) <br /> Descriptlon of Work to Be Done: �� ��- <br /> SII.\N- Q !ZN "e..Y-Y,-, <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that I have read and examined aria application arra know the same to be true and I Y� <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whothor speoifled herein ornot. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the proyisioos of any other state or local law regulating construction or the <br /> performance of conwntatidn. That I arrt auihorh2ed by the owrlerof this property to perform tho 1 -- I <br /> work for which application is made and I comply with the State Contractors Law 16.27 ROW arra <br /> 296.200 WAC_ <br /> 4---f77 <br /> ►pl ��o l 13 <br /> Signature ate <br /> REVISED 2f"f9 <br /> 1 of 1 4/8/2013 9:24 AM <br />