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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 />� � r � ,P�� � A-�� <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />State/Zip <br />Phone <br />J�r.�sa►s �� � ��u �� G c� � t � r � P�,� � A�v� �r� � ._ � l <br />Tenant Maii Address City State/Zip Phone <br />G�lk��o�0 Ed.E[�2c� t�,� 104-2� t�2�cr� �� gv�! ul�u+�lvJoa-o �xA�- 9S`o37 <br />EleCtriCal ContraCtor Mail Address City State/Zip t.�� �� ytlqpgn <br />4'!/J R,.�., <br />A�u���`i Z� G7 <br />State License Number <br />�( I�Gwt�G�[ c l�dwl�G <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: �� � � " � %� �� � �a <br />� iZaa. G� <br />Contract Price of Work <br />i'� ' � ��� / <br />Contact Person (A Pla� R� iew �b� <br />u��/f�i <br />��'IkL P.o� G Ta�P uN �� <br />uSt t�G(� �C(Si ��..F (� tl.t�/k�vJ1A�►�/, G���LD !7D �i Gl��� ��i� �L. <br />�ivl ��1' �1 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. A!1 provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The grantin f a permit does not presume to give aufhority to <br />violate or cancel the provisions of any othe st te or I al law regulating construction or the <br />performan of construction. Th�` I am a tho ized y he owner of this property to perform the <br />296.20r �i � applicayP�� is m�c�Q and I om ly w h e State Contractors Ly�fW 18.27%RCW and <br />� � // / / <br />REVISED 3/20/13 <br />FEE <br />� ��U <br />PERMIT# <br />Ef���l-�5 <br />